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If Yes, what type(s) of ID do you have?
Do you receive SSD? YesNo
Do you have any mental or physical limitations? YesNo
Do you have Medicaid? YesNo
Do you receive SNAP (food stamps) assistance? YesNo
Do you receive Cash Assistance? YesNo
Do you need Legal assistance? YesNo
Are you a veteran? YesNo
If a veteran, are you service connected? YesNo
Do You Receive SSI? YesNo