Get Help
Request care
Tell us what is going on. No referral, no insurance, no diagnosis needed.
Start a care request
This form is delivered by JotForm on a HIPAA-enabled plan so that health information is handled correctly. Nothing you type is stored on this website.
It takes about five minutes. If you get stuck, stop and call instead — an incomplete form is still worth sending.
Prefer to talk to a person? Call (314) 250-5100 or text (314) 886-5902, or email care@valormedica.org.
This form is not monitored around the clock
If you are in danger now, call or text 988 (veterans press 1) or call 911. Do not wait for a reply to a form.
Other ways to reach us
Call
(314) 250-5100
Text
(314) 886-5902
Texting is often easier if you are somewhere you cannot talk.
Email
care@valormedica.org
In person
4477 Woodson Rd, Suite 210
St. Louis, MO 63134
If you are already working with a Valor Villages case manager, ask them — they can start this for you.
Before you send it
What happens after you send this
We aim to respond within two business days. If what you describe sounds urgent, we will say so and direct you somewhere faster rather than leaving you waiting on us — see our emergency and crisis resources.
What to include, and what you can leave out
Include a way to reach you and a rough sense of what is going on. That is genuinely enough. You do not need a diagnosis, you do not need your history organized, and you do not need to explain your housing situation before being taken seriously.
If you do not have a reliable phone, say so and give us any other route — a case manager, a shelter, an email you check occasionally, a relative. We will use whatever works rather than defaulting to a number that is switched off.
If you are asking on someone else’s behalf
That is fine and it is common. Tell us your relationship to the person and whether they know you are contacting us. We will not turn up unannounced where somebody has not agreed to be contacted.
Privacy
What you tell us stays with the clinical team. Information moves to another organization only with your consent, and a request for care is never shared with a landlord, an employer or an immigration authority. Your housing situation is clinical context, not something to be reported.
If you have asked before and nothing happened
Ask again, and say that it happened. Requests fall through for practical reasons — a phone that stopped working, a message that went to a full inbox, a period when we were short-staffed. It is not a judgment about you and it is not a reason to stop asking.