CLAIM Counselor Application

To qualify for this volunteer position, individuals must complete an application, provide three references and sign a conflict of interest and confidentiality statement.

You may complete an online application, or download a printed form (PDF, 198K).

If you prefer the latter, please fax the completed form to 573-817-8330 or mail it to:

CLAIM Program
200 N. Keene St.
Suite 101
Columbia, MO 65201

For additional information contact the CLAIM program at 1-800-390-3330 or e-mail dsims@primaris.org.