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Renee Gullickson, DNP, ARP, FNPC, MSNBC Wellness Provider INTAKE FORM to be filled out prior to first appointment Full Name: Date of birth: Mailing Address: Email: Cell phone: Home phone: Work phone:
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Who needs ruth ellis center?

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The Ruth Ellis Center is needed by LGBTQ+ youth who are experiencing homelessness or facing challenges in their lives
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It is also beneficial for community members, allies, and organizations who want to support and advocate for LGBTQ+ youth
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Ruth Ellis Center provides a safe and accepting environment, housing, counseling, and other resources to help LGBTQ+ youth thrive
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The Ruth Ellis Center is a non-profit organization that provides support, services, and safe spaces for LGBTQ+ youth in Michigan, helping them address issues such as homelessness, mental health, and educational support.
The Ruth Ellis Center does not require a filing; however, individuals or organizations seeking to utilize its services may need to complete certain intake forms or applications to receive support.
To access services at the Ruth Ellis Center, individuals typically must fill out an intake form available on their website or at the center, which includes personal information and a brief assessment of needs.
The purpose of the Ruth Ellis Center is to empower LGBTQ+ youth by providing them with housing, health services, and supportive programs that promote their dignity and well-being.
Information collected by the Ruth Ellis Center usually includes basic personal details, demographics, and specific needs related to housing, health care, and support services.
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