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For more information, complete our intake form. A Manna representative will connect with you to explore how we can best support your journey.
Name
Age
Email Address
Phone Number
Are you currently enrolled in the Self-Determination Program (SDP)?
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No, but interested in joining
Not sure what SDP is
Yes, enrolled
No, not interested
If you are not yet enrolled, would you like Manna Unlimited to assist you with the enrollment process?
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Yes, I want help enrolling
Maybe, I’d like to learn more
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N/A
What Regional Center are you with?
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SCLARC
North LA
Harbor
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What type of supports are you seeking
Employment / Job Coaching
Independent Living Skills
Vendor / Service Navigation
Independent Facilitator
Other
What is your #1 goal for your loved one right now?
Are there specific challenges you’re facing?
How soon would you like support?
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Immediately
1–3 Months
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Best time to contact you:
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