Take the first step toward support and connection
with Healthy Families America® today.

Before You Begin

Thank you for your interest in Healthy Families America®. This form helps us learn a little more about you and your family so we can see if the program may be a good fit.

HFA® is designed for individuals and families who meet the following criteria:

Pregnant individuals in their third trimester
Parents or caregivers of an infant age 0–3 months
Foster parents or families with a child age 2 or younger (active child welfare case)
Residents within the program’s service area
Interested in participating in a home visiting program for 3–5 years
Available for regular (typically weekly) home visits at their primary residence

Participation is always voluntary, and a Koinonia staff member will follow up to discuss next steps.

Name(Required)

Email Address(Required)

Primary Language(Required)

Other Language(Required)

Phone Number(Required)

Best Time to Call(Required)

Preferred Contact Method(Required)

Physical Address(Required)

City(Required)

State(Required)

Which county do you live in?(Required)

Healthy Families America® is currently available in select counties. If you live outside these areas, we’re still happy to connect you with information or help explore other options.

Zip(Required)

Please Select Your County(Required)

Is there anything you'd like us to know or any questions you have?

How Did You Hear About Koinonia?(Required)

Marketing

Yes, add me to Koinonia's newsletter list.

Take the first step toward support and connection with Healthy Families America® today.

Before You Begin

Take the first step toward support and connection
with Healthy Families America® today.