Name *
Phone *
Date of Birth
Date of Birth

If you would more information, or want to contact the staff or providers at CityCare, please fill out the form below, give us a call at (402) 916-9421, or email us at  

If you are feeling unsafe with yourself, or know of someone feeling unsafe, please call this confidential suicide prevention hotline: 1-800-448-3000.  

If this is a medical emergency or if you are in danger, please call 911.