Connect Now

Fill out the form below during regular business hours, and you will receive a call back from one of our BETE staff ready to help you.

Name(Required)

First Last

Your Relationship to the Person Needing Benefits/Care(Required)

Client (who is in need of benefits/care?)(Required)

Email(Required)

Phone(Required)

Would you prefer to be contacted by phone or email(Required)

In what county does the person needing care reside?(Required)

In what type of setting are they currently?(Required)

In what benefits are you interested?(Required)

How did you learn about BETE?(Required)

How Can We Help You?:(Required)