Caring Souls for Veterans  ·  501(c)(3)

Join Our Community

Whether you’re seeking membership, enrolling in a program, or ready to serve alongside us — you belong here.

1 General Membership
2 Program Registration
3 Volunteer & Ambassador

Scroll to begin






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Form 01
General Membership Registration
Access resources, community, and support — free for transitioning military healthcare professionals.

Data Privacy & HIPAA Notice

This form collects health-adjacent information (wellbeing status, VA disability rating, housing situation). CSV treats this data as sensitive and stores it in encrypted, access-controlled systems. It is never sold, shared with advertisers, or disclosed to third parties without your explicit written consent.

Access is restricted to authorized CSV staff involved in program delivery. You may request deletion of your data at any time by emailing privacy@caringsoulsforveterans.org. CSV is not a HIPAA-covered entity but voluntarily adopts equivalent data handling standards.

Need immediate support? Call or text 988, press 1 — Veterans Crisis Line, available 24 hours a day. This form is not monitored for emergencies.

Your progress is saved automatically as you type.
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Where Are You in Your Transition?

Your answers to these two questions will help us highlight the most relevant parts of this form.

Transition stage *
Select…Still active — preparing to separateJust separated — getting orientedIn licensing / credentialing processJob searching in civilian healthcareEmployed — navigating the new environmentConsidering further education or leadership
Primary healthcare role *
Select…Registered Nurse (RN)Advanced Practice Nurse (NP / CRNA / CNM)Physician (MD / DO)Physician Assistant (PA)PharmacistDentist / Dental OfficerPhysical / Occupational TherapistBehavioral / Mental Health ProviderMedical / Healthcare AdministratorParamedic / Combat Medic / CorpsmanRadiology / Imaging TechnologistLaboratory / Pathology ProfessionalOther Healthcare Professional

Personal Information
First Name *

First name is required.
Last Name *

Last name is required.
Email Address *

Please enter a valid email address.
Phone Number

Please enter a valid phone number.
State / Territory *
Select state…AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWashington D.C.Puerto RicoGuamOther U.S. Territory
ZIP Code

Preferred Communication Method
Select…EmailPhone callText / SMSVideo callNo preference
Preferred Pronouns
Select or skip…She / HerHe / HimThey / ThemShe / TheyHe / TheyOther / self-describePrefer not to say

Military Background
Branch of Service *
Select branch…ArmyNavyAir ForceMarine CorpsCoast GuardSpace ForceNational GuardReserves
Service Status *
Select…Active Duty (within 24 months of separation)Recently Separated (0–2 years)Veteran (2+ years post-separation)Retired MilitaryReservist / National Guard
Separation / Retirement Date (Est.)

Rank at Separation


Healthcare Role
Years of Clinical Experience
Select range…Less than 2 years2–5 years6–10 years11–20 years20+ years
Current / Most Recent Employer


VA Status & Wellbeing
VA Disability Rating (if applicable)
Select…0%10–20%30–40%50–60%70–80%90–100%Pending / in processNot rated / not applicablePrefer not to say
VA Healthcare Enrollment Status
Select…Enrolled and activeEnrolled but not currently usingNot enrolled — eligible but haven’t appliedNot enrolled — not eligibleIn process of enrollingUnsure of eligibility

Wellbeing Check-In

This is not a clinical assessment. Over the last two weeks, how often have you felt down, hopeless, or had little interest or pleasure in doing things?

Not at all
Several days
More than half the days
Nearly every day

If you are in crisis right now, please call or text 988, press 1 — Veterans Crisis Line, 24 hours a day.

Current Housing Situation
Select…Stable — own or long-term leaseStable — living with family or partnerTemporary — short-term or transitionalUnstable — at risk of losing housingExperiencing homelessnessPrefer not to say
Optional. Helps CSV connect you to the right resources quickly.
Gender Identity
Select or skip…WomanManNon-binaryGenderqueer / Gender fluidTransgenderTwo-spiritPrefer to self-describePrefer not to say
Race / Ethnicity (optional, aggregate research only)
Select or skip…American Indian or Alaska NativeAsian or Asian AmericanBlack or African AmericanHispanic, Latino, or Spanish originMiddle Eastern or North AfricanNative Hawaiian or Pacific IslanderWhite or CaucasianMultiracial / MixedPrefer to self-describePrefer not to say
Accessibility or Accommodation Needs


Emergency Contact
Full Name *

Required.
Relationship *
Select…Spouse / PartnerParentSiblingChild (adult)FriendOther family memberOther
Phone Number *

Required.

What Are You Looking For?
Select all that apply
Peer support and community connection
Licensure and credentialing guidance
Employment and career resources
Financial planning and stability tools
Mental health and performance support
Code PURPLE peer support program
Operation ReWire (for nurses)
Leadership development and advancement

One More Thing
How did you hear about CSV?
Select…Fellow veteran or colleagueSocial mediaLinkedInMilitary transition program or TAPHealthcare employer or organizationSearch engineMOAA / AMSUS / ACHE partnerOther
Referral Name (if applicable)

Anything else you’d like us to know?


Supporting Documents (optional)

Uploading documents helps CSV verify your service and match you to the right resources. All files are encrypted. Max 10 MB per file.

✕

🪖
DD-214
Certificate of Release or Discharge from Active Duty
PDF · JPG · PNG
✕

🪪
Professional License
Active nursing, medical, or specialty license
PDF · JPG · PNG
✕

📋
Certification
Board cert, ANCC, or specialty credential
PDF · JPG · PNG
✕

📄
Resume / CV
Current civilian or military resume
PDF · DOC · DOCX

🔒 Documents are encrypted in transit and at rest. You may also email documents to documents@caringsoulsforveterans.org.

By submitting this form, you consent to being contacted by Caring Souls for Veterans (CSV) regarding membership resources, programs, and relevant opportunities. Your information will never be sold or shared with third parties outside of CSV program partners without your explicit consent. View our full Privacy Policy and Terms of Service.

CSV is a 501(c)(3) nonprofit organization. This form is not monitored 24/7 — for crisis support, call or text 988, press 1.

I confirm I am 18 years of age or older and agree to CSV’s Privacy Policy and Terms of Service. *



I understand that health-adjacent information I provide will be handled with equivalent HIPAA-level care by CSV staff.



I’m open to being contacted about CSV research opportunities (HOW Factor National Study, POISE assessment).



I consent to a brief 30-day and 90-day follow-up to share how my transition is progressing.



Subscribe me to the ReWire Report newsletter.








Fields marked * are required. Your submission is secure and confidential.

Register as Member →


✓

Welcome to the CSV Community

Your registration has been received. A member of the CSV team will be in touch within 2 business days. You earned this. We’re glad you’re here.

🎯
Form 02
Program Registration
Enroll in Code PURPLE, Operation ReWire, CHAIS, or other CSV programs.

Data Privacy & HIPAA Notice

Program registration data is stored securely in CSV’s CiviCRM system with role-based access controls. Health-adjacent information is treated with equivalent HIPAA-level care. View our Privacy Policy for full details.

Need immediate support? Call or text 988, press 1 — Veterans Crisis Line, available 24 hours a day.
Your progress is saved automatically as you type.
✓ Saved
Save & continue later

Personal Information
First Name *

First name is required.
Last Name *

Last name is required.
Email Address *

Please enter a valid email address.
Phone Number *

Please enter a valid phone number.
State / Territory *
Select state…AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWashington D.C.Puerto RicoGuam
Time Zone *
Select…Eastern (ET)Central (CT)Mountain (MT)Pacific (PT)Alaska (AKT)Hawaii (HT)
Preferred Communication Method
Select…EmailPhone callText / SMSVideo callNo preference
Preferred Pronouns
Select or skip…She / HerHe / HimThey / ThemShe / TheyHe / TheyOther / self-describePrefer not to say

Program Selection
Which program are you registering for? *
Select a program…Code PURPLE — Peer Support ProgramOperation ReWire — For NursesCHAIS — Healthcare Administration CredentialingMilitary Healthcare Honors / Ambassador ProgramOther / Not Sure Yet
Code PURPLE is CSV’s peer support cohort for military healthcare professionals. Cohorts are facilitated by trained veteran peers and meet virtually over 8 weeks.
Preferred Cohort StartSelect…Next availableWithin 30 days1–3 months from now3–6 months from nowFlexible
Session Format PreferenceSelect…Virtual (video)Virtual (phone)No preference
What are you hoping to get out of Code PURPLE?
Operation ReWire is designed specifically for military nurses transitioning to civilian healthcare systems. The program addresses licensure, cultural translation, and professional identity.
Nursing License Status *Select…Active military license onlyIn process of civilian licensureCivilian license obtainedCompact license holder
Nursing Specialty
Primary challenge in your nursing transition
CHAIS provides healthcare administration credentialing pathways for transitioning military healthcare professionals. Scholarship opportunities are available.
Current Healthcare Role
Interested in Scholarship?Select…Yes — please send scholarship infoNo — I plan to self-fundNot sure yet

Military & Professional Background
Branch *Branch…ArmyNavyAir ForceMarine CorpsCoast GuardSpace ForceNational GuardReserves
Service Status *Status…Active Duty (pre-separation)Recently Separated (0–2 yrs)Veteran (2+ yrs)Retired
Primary Role *Role…RNNP / APRNPhysicianPAPharmacistDentistPT / OTBehavioral HealthHealthcare AdminMedic / CorpsmanOther

Program Readiness
Prior CSV program participation
Select…No — this is my first CSV programYes — Code PURPLEYes — Operation ReWireYes — CHAISYes — Ambassador / HonorsYes — multiple programs
Device available for virtual sessions *
Select…Laptop or desktop computerTabletSmartphone onlyPhone (audio only)No reliable device — I need support
Internet access reliability *
Select…Reliable broadband at homeReliable — mobile data onlyInconsistent — occasional outagesLimited — rural or base restrictionsNo reliable access — I need support
VA Disability Rating (if applicable)
Select…0%10–20%30–40%50–60%70–80%90–100%PendingNot ratedPrefer not to say
What are your 1–3 specific goals for this program? *

Specific goals help coordinators tailor your experience and measure outcomes over time.

Availability
Best days for program sessions
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Preferred time of daySelect…Morning (6 AM – 12 PM)Afternoon (12 PM – 5 PM)Evening (5 PM – 9 PM)Flexible
Scheduling conflicts to note?

Emergency Contact
Full Name *Required.
Relationship *Select…Spouse / PartnerParentSiblingChild (adult)FriendOther
Phone Number *Required.

Identity & Inclusion (all optional)
Gender IdentitySelect or skip…WomanManNon-binaryGenderqueer / Gender fluidTransgenderTwo-spiritPrefer to self-describePrefer not to say
Race / EthnicitySelect or skip…American Indian or Alaska NativeAsian or Asian AmericanBlack or African AmericanHispanic, Latino, or Spanish originMiddle Eastern or North AfricanNative Hawaiian or Pacific IslanderWhite or CaucasianMultiracial / MixedPrefer to self-describePrefer not to say
Accessibility Needs

Supporting Documents (optional)
✕

🪖DD-214
Certificate of Release or Discharge
PDF · JPG · PNG
✕

🪪Professional License
Current or pending clinical license
PDF · JPG · PNG
✕

🎓Military Transcript
AARTS, SMARTS, or JST
PDF · JPG · PNG
✕

📎Additional Document
Any other supporting documentation
PDF · JPG · DOC

🔒 Encrypted in transit and at rest. Email: documents@caringsoulsforveterans.org

By registering for a CSV program, you consent to being contacted regarding enrollment, scheduling, and program communications. View our Privacy Policy and Terms of Service.

I confirm I am 18 years or older and agree to CSV’s Privacy Policy and Terms of Service. *
I’m open to being contacted about CSV research opportunities (HOW Factor / POISE).
I consent to a brief 30-day and 90-day follow-up to share how my transition is progressing.





A CSV program coordinator will contact you within 3 business days.

Submit Registration →


✓

Registration Received

A CSV program coordinator will reach out within 3 business days to confirm your enrollment and next steps. Mission accepted.

🌟
Form 03
Volunteer & Ambassador Sign-Up
Join the mission as a peer, mentor, ambassador, or organizational liaison.

Data Privacy Notice

Volunteer application data is stored securely in CSV’s CiviCRM system. Background check results are reviewed only by authorized CSV leadership and never shared with third parties. View our Privacy Policy.

Your progress is saved automatically as you type.
✓ Saved
Save & continue later

Personal Information
First Name *Required.
Last Name *Required.
Email Address *Please enter a valid email.
Phone Number *Required.
LinkedIn Profile URL
State / Territory *Select state…AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWashington D.C.Puerto RicoGuam
Preferred PronounsSelect or skip…She / HerHe / HimThey / ThemShe / TheyHe / TheyOtherPrefer not to say
Preferred Communication MethodSelect…EmailPhone callText / SMSNo preference

Your Background
Branch *Branch…ArmyNavyAir ForceMarine CorpsCoast GuardSpace ForceNational GuardReserves
Service Status *Status…Active DutyRecently SeparatedVeteranRetired
Years Post-SeparationSelect…Currently servingLess than 1 year1–3 years3–5 years5–10 years10+ years
Current Civilian Role / Title
Current Employer / Organization
Highest Degree or Certification
VA Disability Rating (if applicable)Select…0%10–20%30–40%50–60%70–80%90–100%PendingNot ratedPrefer not to say

How You Want to Serve
Select all roles you’re interested in *
Code PURPLE Peer Supporter — Facilitate peer cohort sessions
CSV Ambassador — Represent CSV in your professional network
Mentor — One-on-one guidance for a transitioning professional
Subject Matter Expert — Licensure, finance, leadership, or specialty
Speaker / Presenter — CSV events, webinars, or partner conferences
Military Healthcare Honors Program — Recognize outstanding professionals
Corporate / Organizational Liaison — Connect your employer to CSV’s mission
Research Contributor — Support HOW Factor / POISE initiatives

Capacity & Commitment
Hours available per month *Select…1–2 hours3–5 hours5–10 hours10+ hoursFlexible / project-based
Preferred engagement formatSelect…Virtual onlyIn-person onlyBothNo preference
Why do you want to volunteer with CSV? *
Relevant skills, certifications, or specialties

Emergency Contact
Full Name *Required.
Relationship *Select…Spouse / PartnerParentSiblingChild (adult)FriendOther
Phone Number *Required.

VA Status
VA Disability Rating (if applicable)Select…0%10–20%30–40%50–60%70–80%90–100%PendingNot ratedPrefer not to say
VA Healthcare Enrollment StatusSelect…Enrolled and activeEnrolled but not currently usingNot enrolled — eligibleNot enrolled — not eligibleIn processUnsure

Identity & Inclusion (all optional)
Gender IdentitySelect or skip…WomanManNon-binaryGenderqueer / Gender fluidTransgenderTwo-spiritPrefer to self-describePrefer not to say
Race / EthnicitySelect or skip…American Indian or Alaska NativeAsian or Asian AmericanBlack or African AmericanHispanic, Latino, or Spanish originMiddle Eastern or North AfricanNative Hawaiian or Pacific IslanderWhite or CaucasianMultiracial / MixedPrefer to self-describePrefer not to say
Accessibility Needs

Reference (Optional)

A fellow veteran, colleague, or CSV contact helps us match you to the right role faster.

Reference Name
Reference Contact

Background Check Consent
Peer support, mentorship, and ambassador roles require a standard background check prior to activation. This is a one-time process managed by CSV’s volunteer onboarding team. Results are reviewed confidentially and do not automatically disqualify an applicant.
I consent to a background check as part of CSV volunteer onboarding. *
I understand background check results are reviewed confidentially by CSV leadership only.
Have you ever been convicted of a felony or misdemeanor? (excluding sealed, expunged, or juvenile records)
No
Yes — please explain
Please provide context

Conflict of Interest Disclosure

A disclosed conflict does not automatically disqualify you — undisclosed conflicts discovered later may.

Are you employed by, contracted with, or affiliated with any organization that competes with or has a financial relationship with CSV? *
No
Yes — please describe below
Please describe the affiliation *
Do any immediate family members hold a position with an organization that has a relationship with CSV?
No
Yes — please describe below
Please describe the family member’s affiliation
Have you ever been disciplined or asked to resign from a volunteer or professional role for ethics or conduct reasons?
No
Yes — please describe below
Please provide context
By completing this section, you affirm the information is accurate. If a conflict arises after submission, you agree to disclose it promptly to CSV leadership.

Supporting Documents (optional)
✕

🪖DD-214
Certificate of Release or Discharge
PDF · JPG · PNG
✕

📄Resume / CV
Current professional resume
PDF · DOC · DOCX
✕

🪪Professional License
Required for peer support roles
PDF · JPG · PNG
✕

📋Peer Support / Training Cert
Peer support or coaching certificates
PDF · JPG · PNG

🔒 Encrypted in transit and at rest. Email: documents@caringsoulsforveterans.org

By submitting this form, you consent to being contacted by CSV regarding volunteer opportunities and mission-related communications. View our Privacy Policy and Terms of Service.

I confirm I am 18 years or older and agree to CSV’s Privacy Policy, Terms of Service, and volunteer code of conduct. *
I understand that peer support roles require a brief onboarding process before activation.
I’m open to being contacted about CSV research opportunities (HOW Factor / POISE).





Applications are reviewed within 5 business days. We’ll schedule a brief orientation call.

Submit Application →


🌟

Application Submitted — Thank You

The CSV team will review it and reach out within 5 business days to discuss next steps. We’re honored to serve alongside you.

Caring Souls for Veterans  ·  501(c)(3)  · 
caringsoulsforveterans.org  · 
Privacy Policy  · 
Terms of Service  · 
Crisis line: 988, press 1