Nexa Home Connect

HSS Providers: Request a Housing Consultation

*Client name

*Client birth date

Month

Day

Year

Client PMI or Medicaid number (if known)

*Client phone number

Please add +1 before the phone number.

Client email

HSS Provider (if selected)

HSS Provider's NPI or UMPI (if known)

HSS Provider's Phone (optional)

Please add +1 before the phone number.

HSS Provider's Email (optional)

HSS Provider's Address (optional)

Would you prefer to meet in person or on the phone?

In-person

On the phone

Best day to meet

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Best time to meet

8am-10am

10am-noon

Noon-2pm

2pm-4pm

Nexa Home Connect

Please attach PSN (DHS 7122, updated August 2024)

https://edocs.dhs.state.mn.us/lfserver/Public/DHS-7122-ENG

Phone 612-888-6392
Kirstin@nexahomeconnect.com
Dan@nexahomeconnect.com

PO Box 3611

Minneapolis, MN 55403

Fax 612-234-4524
NPI 1851089809

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HSS providers: request a consultation

Join us as a co-worker

Current clients: signature required

At Nexa Home Connect, home is a first priority.

At home we find our joy, our strength, and our capacity to care for ourselves and one another.

Our community of clients and advocates is courageous, resilient, and passionate about housing stability for all.

Nexa Home Connect does not discriminate on the basis of race, color, national origin, sex, age, or disability.

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