www.alexanderjfs.org Open in urlscan Pro
54.194.170.100  Public Scan

Submitted URL: https://r20.rs6.net/tn.jsp?f=001OPaUx--zOXMqUaS8iULjr87gyCnsNNcFe-LVk3VdCaSEB6lJSNa_wu3l0oOgLnJvTm6kdK5mddVwiA7HagKt...
Effective URL: https://www.alexanderjfs.org/services/bmhs/intervention/touching-the-heart
Submission: On May 02 via api from US — Scanned from DE

Form analysis 4 forms found in the DOM

/search

<form action="/search" id="search" class="search w-form">
  <div class="img-search"></div><input type="search" spellcheck="false" class="search-input w-input" maxlength="256" name="query" aria-label="search" placeholder="Search…" id="search-nav" input-type="search" required=""><input type="submit"
    value="Search" class="search-button w-button">
</form>

/search

<form action="/search" id="search" aria-label="search" class="search w-form">
  <div class="img-search"></div><input type="search" class="search-input w-input" maxlength="256" name="query" placeholder="" id="search" required=""><input type="submit" value="Search" class="search-button w-button">
</form>

POST https://jewishfamilyservicesajivu.formstack.com/forms/index.php

<form method="post" accept-charset="UTF-8" novalidate="" enctype="multipart/form-data" action="https://jewishfamilyservicesajivu.formstack.com/forms/index.php" class="fsForm fsSingleColumn" id="fsForm4102567">
  <input type="hidden" name="form" value="4102567">
  <input type="hidden" name="viewkey" value="7G5dnaYtEF">
  <input type="hidden" name="password" value="">
  <input type="hidden" name="hidden_fields" id="hidden_fields4102567" value="">
  <input type="hidden" name="incomplete" id="incomplete4102567" value="">
  <input type="hidden" name="incomplete_password" id="incomplete_password4102567">
  <input type="hidden" name="referrer" id="referrer4102567" value="https://www.alexanderjfs.org/">
  <input type="hidden" name="referrer_type" id="referrer_type4102567" value="js">
  <input type="hidden" name="_submit" value="1">
  <input type="hidden" name="style_version" value="3">
  <input type="hidden" id="viewparam" name="viewparam" value="953294">
  <div id="requiredFieldsError" style="display:none;">Please fill in a valid value for all required fields</div>
  <div id="invalidFormatError" style="display:none;">Please ensure all values are in a proper format.</div>
  <div id="resumeConfirm" style="display:none;">Are you sure you want to leave this form and resume later?</div>
  <div id="resumeConfirmPassword" style="display: none;">Are you sure you want to leave this form and resume later? If so, please enter a password below to securely save your form.</div>
  <div id="saveAndResume" style="display: none;">Save and Resume Later</div>
  <div id="saveResumeProcess" style="display: none;">Save and get link</div>
  <div id="fileTypeAlert" style="display:none;">You must upload one of the following file types for the selected field:</div>
  <div id="embedError" style="display:none;">There was an error displaying the form. Please copy and paste the embed code again.</div>
  <div id="applyDiscountButton" style="display:none;">Apply Discount</div>
  <div id="dcmYouSaved" style="display:none;">You saved</div>
  <div id="dcmWithCode" style="display:none;">with code</div>
  <div id="submitButtonText" style="display:none;">Submit Form</div>
  <div id="submittingText" style="display:none;">Submitting</div>
  <div id="validatingText" style="display:none;">Validating</div>
  <div id="autocaptureDisabledText" style="display:none;"></div>
  <div id="paymentInitError" style="display:none;">There was an error initializing the payment processor on this form. Please contact the form owner to correct this issue.</div>
  <div id="checkFieldPrompt" style="display:none;">Please check the field: </div>
  <div id="translatedWord-fields" style="display:none;">Fields</div>
  <div class="fsPage" id="fsPage4102567-1">
    <div id="ReactContainer4102567" style="display:none" class="FsReactContainerInitApp" data-fs-react-app-id="4102567"></div>
    <div class="fsSection fs1Col">
      <div id="fsRow4102567-1" class="fsRow fsFieldRow fsLastRow">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell100504366" lang="en" fs-field-type="name" fs-field-validation-name="Name">
          <span id="label100504366" class="fsLabel fsRequiredLabel">Name<span class="fsRequiredMarker">*</span></span>
          <div class="fsSubFieldGroup">
            <div class="fsSubField fsNameFirst">
              <input type="text" id="field100504366-first" name="field100504366-first" size="20" aria-label="First Name" value="" required="" class="fsField fsFieldName fsRequired" aria-required="true">
              <label class="fsSupporting fsRequiredLabel" for="field100504366-first">First Name<span class="hidden">*</span></label>
            </div>
            <div class="fsSubField fsNameLast">
              <input type="text" id="field100504366-last" name="field100504366-last" size="20" aria-label="Last Name" value="" required="" class="fsField fsFieldName fsRequired" aria-required="true">
              <label class="fsSupporting fsRequiredLabel" for="field100504366-last">Last Name<span class="hidden">*</span></label>
            </div>
          </div>
          <div class="clear"></div>
        </div>
      </div>
      <div id="fsRow4102567-2" class="fsRow fsFieldRow fsLastRow">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101305843" lang="en" fs-field-type="radio" fs-field-validation-name="Age Range">
          <fieldset role="group" aria-labelledby="fsLegend101305843" id="label101305843">
            <legend id="fsLegend101305843" class="fsLabel fsRequiredLabel fsLabelVertical"><span>Age Range<span class="fsRequiredMarker">*</span></span></legend>
            <div class="fieldset-content">
              <label class="fsOptionLabel vertical" for="field101305843_1"><input type="radio" id="field101305843_1" name="field101305843" value="Under 18" class="fsField fsRequired vertical" aria-required="true">Under 18</label>
              <label class="fsOptionLabel vertical" for="field101305843_2"><input type="radio" id="field101305843_2" name="field101305843" value="18-24" class="fsField fsRequired vertical" aria-required="true">18-24</label>
              <label class="fsOptionLabel vertical" for="field101305843_3"><input type="radio" id="field101305843_3" name="field101305843" value="24-30" class="fsField fsRequired vertical" aria-required="true">24-30</label>
              <label class="fsOptionLabel vertical" for="field101305843_4"><input type="radio" id="field101305843_4" name="field101305843" value="30-40" class="fsField fsRequired vertical" aria-required="true">30-40</label>
              <label class="fsOptionLabel vertical" for="field101305843_5"><input type="radio" id="field101305843_5" name="field101305843" value="40-50" class="fsField fsRequired vertical" aria-required="true">40-50</label>
              <label class="fsOptionLabel vertical" for="field101305843_6"><input type="radio" id="field101305843_6" name="field101305843" value="50-60" class="fsField fsRequired vertical" aria-required="true">50-60</label>
              <label class="fsOptionLabel vertical" for="field101305843_7"><input type="radio" id="field101305843_7" name="field101305843" value="60+" class="fsField fsRequired vertical" aria-required="true">60+</label>
            </div>
          </fieldset>
        </div>
      </div>
      <div id="fsRow4102567-3" class="fsRow fsFieldRow fsLastRow">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell100504374" lang="en" fs-field-type="email" fs-field-validation-name="At what email address would you like to be contacted?">
          <label id="label100504374" class="fsLabel" for="field100504374">At what email address would you like to be contacted? </label>
          <input type="email" id="field100504374" name="field100504374" size="50" value="" class="fsField fsFormatEmail">
        </div>
      </div>
      <div id="fsRow4102567-4" class="fsRow fsFieldRow fsLastRow">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell100504470" lang="en" fs-field-type="phone" fs-field-validation-name="What phone number would you like to receive your Touching the Heart messages?">
          <label id="label100504470" class="fsLabel fsRequiredLabel" for="field100504470">What phone number would you like to receive your Touching the Heart messages?<span class="fsRequiredMarker">*</span> </label>
          <input type="tel" id="field100504470" name="field100504470" size="2" required="" value="" class="fsField fsFormatPhoneUS  fsRequired" aria-required="true" data-country="US" data-format="national">
        </div>
      </div>
      <div id="fsRow4102567-5" class="fsRow fsFieldRow fsLastRow">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell100504475" lang="en" fs-field-type="radio" fs-field-validation-name="What is your life phase?">
          <fieldset role="group" aria-labelledby="fsLegend100504475" id="label100504475">
            <legend id="fsLegend100504475" class="fsLabel fsRequiredLabel fsLabelVertical"><span>What is your life phase?<span class="fsRequiredMarker">*</span></span></legend>
            <div class="fieldset-content">
              <label class="fsOptionLabel vertical" for="field100504475_1"><input type="radio" id="field100504475_1" name="field100504475" value="High School Student" class="fsField fsRequired vertical" aria-required="true">High School
                Student</label>
              <label class="fsOptionLabel vertical" for="field100504475_2"><input type="radio" id="field100504475_2" name="field100504475" value="Higher Education Student" class="fsField fsRequired vertical" aria-required="true">Higher Education
                Student</label>
              <label class="fsOptionLabel vertical" for="field100504475_3"><input type="radio" id="field100504475_3" name="field100504475" value="Young Professional" class="fsField fsRequired vertical" aria-required="true">Young Professional</label>
              <label class="fsOptionLabel vertical" for="field100504475_4"><input type="radio" id="field100504475_4" name="field100504475" value="Parent" class="fsField fsRequired vertical" aria-required="true">Parent</label>
            </div>
          </fieldset>
        </div>
      </div>
      <div id="fsRow4102567-6" class="fsRow fsFieldRow fsLastRow fsHidden">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100" id="fsCell100504509" lang="en" fs-field-type="text" fs-field-validation-name="What is the name of your school or organization?">
          <label id="label100504509" class="fsLabel" for="field100504509">What is the name of your school or organization? </label>
          <input type="text" id="field100504509" name="field100504509" size="50" value="" class="fsField fsFormatText    " disabled="disabled">
        </div>
      </div>
      <div id="fsRow4102567-7" class="fsRow fsFieldRow fsLastRow">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell100504514" lang="en" fs-field-type="number" fs-field-validation-name="Zip Code">
          <label id="label100504514" class="fsLabel fsRequiredLabel" for="field100504514">Zip Code<span class="fsRequiredMarker">*</span> </label>
          <input type="number" step="any" id="field100504514" name="field100504514" required="" class="fsField fsFormatNumber fsNumberMin-1 fsNumberMax-99999 fsNumberDecimals-0 fsRequired" min="1" max="99999" aria-required="true">
          <script>
            //This script is to address some quirkiness of Safari where commas are interchangeable with decimal points on number fields.
            //Normal attempts to restrict the comma such as our own validation or .replace(",", "") results in the value of the field being removed entirely.
            //Below the keypress itself is being blocked as a workaround to keep our value.
            document.getElementById("field100504514").addEventListener("keydown", function blockComma(e) {
              if (e.code === 'Comma') {
                e.preventDefault();
              }
            })
          </script>
        </div>
      </div>
      <div id="fsRow4102567-8" class="fsRow fsFieldRow fsLastRow">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell100504807" lang="en" fs-field-type="radio" fs-field-validation-name="What is your gender?">
          <fieldset role="group" aria-labelledby="fsLegend100504807" id="label100504807">
            <legend id="fsLegend100504807" class="fsLabel fsRequiredLabel fsLabelVertical"><span>What is your gender?<span class="fsRequiredMarker">*</span></span></legend>
            <div class="fieldset-content">
              <label class="fsOptionLabel vertical" for="field100504807_1"><input type="radio" id="field100504807_1" name="field100504807" value="Female" class="fsField fsRequired vertical" aria-required="true">Female</label>
              <label class="fsOptionLabel vertical" for="field100504807_2"><input type="radio" id="field100504807_2" name="field100504807" value="Male" class="fsField fsRequired vertical" aria-required="true">Male</label>
              <label class="fsOptionLabel vertical" for="field100504807_3"><input type="radio" id="field100504807_3" name="field100504807" value="Non-Binary" class="fsField fsRequired vertical" aria-required="true">Non-Binary</label>
              <label class="fsOptionLabel vertical" for="field100504807_4"><input type="radio" id="field100504807_4" name="field100504807" value="Prefer not to say" class="fsField fsRequired vertical" aria-required="true">Prefer not to say</label>
              <div class="vertical fs-clear">
                <label class="fsOptionLabel vertical" for="field100504807_other"><input type="radio" id="field100504807_other" name="field100504807" value="Other" class="fsField fsRequired" aria-required="true">Other:</label>
                <input type="text" id="field100504807_othervalue" name="field100504807_other" size="15" class="fsOtherField" aria-required="true"><label class="fsHiddenLabel" style="display: none;" for="field100504807_othervalue">Other Value</label>
              </div>
            </div>
          </fieldset>
        </div>
      </div>
      <div id="fsRow4102567-9" class="fsRow fsFieldRow fsLastRow">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell100505068" lang="en" fs-field-type="radio" fs-field-validation-name="What is your race or ethnicity? ">
          <fieldset role="group" aria-labelledby="fsLegend100505068" id="label100505068">
            <legend id="fsLegend100505068" class="fsLabel fsRequiredLabel fsLabelVertical"><span>What is your race or ethnicity? <span class="fsRequiredMarker">*</span></span></legend>
            <div class="fieldset-content">
              <label class="fsOptionLabel vertical" for="field100505068_1"><input type="radio" id="field100505068_1" name="field100505068" value="Asian" class="fsField fsRequired vertical" aria-required="true">Asian</label>
              <label class="fsOptionLabel vertical" for="field100505068_2"><input type="radio" id="field100505068_2" name="field100505068" value="Black or African American" class="fsField fsRequired vertical" aria-required="true">Black or African
                American</label>
              <label class="fsOptionLabel vertical" for="field100505068_3"><input type="radio" id="field100505068_3" name="field100505068" value="Hispanic or Latino" class="fsField fsRequired vertical" aria-required="true">Hispanic or Latino</label>
              <label class="fsOptionLabel vertical" for="field100505068_4"><input type="radio" id="field100505068_4" name="field100505068" value="Middle Eastern or North African" class="fsField fsRequired vertical" aria-required="true">Middle Eastern
                or North African</label>
              <label class="fsOptionLabel vertical" for="field100505068_5"><input type="radio" id="field100505068_5" name="field100505068" value="Multiracial or Multiethnic" class="fsField fsRequired vertical" aria-required="true">Multiracial or
                Multiethnic</label>
              <label class="fsOptionLabel vertical" for="field100505068_6"><input type="radio" id="field100505068_6" name="field100505068" value="Native American or Alaska Native" class="fsField fsRequired vertical" aria-required="true">Native
                American or Alaska Native</label>
              <label class="fsOptionLabel vertical" for="field100505068_7"><input type="radio" id="field100505068_7" name="field100505068" value="Native Hawaiian or other Pacific Islander" class="fsField fsRequired vertical"
                  aria-required="true">Native Hawaiian or other Pacific Islander</label>
              <label class="fsOptionLabel vertical" for="field100505068_8"><input type="radio" id="field100505068_8" name="field100505068" value="White" class="fsField fsRequired vertical" aria-required="true">White</label>
              <div class="vertical fs-clear">
                <label class="fsOptionLabel vertical" for="field100505068_other"><input type="radio" id="field100505068_other" name="field100505068" value="Other" class="fsField fsRequired" aria-required="true">Other:</label>
                <input type="text" id="field100505068_othervalue" name="field100505068_other" size="15" class="fsOtherField" aria-required="true"><label class="fsHiddenLabel" style="display: none;" for="field100505068_othervalue">Other Value</label>
              </div>
            </div>
          </fieldset>
        </div>
      </div>
    </div>
    <div class="fsSection fs1Col fsHidden" id="fsSection101305991">
      <div class="fsSectionHeader">
        <h2 class="fsSectionHeading">Parent Group Information</h2>
      </div>
      <div id="fsRow4102567-11" class="fsRow fsFieldRow fsLastRow">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101306076" lang="en" fs-field-type="radio" fs-field-validation-name="Marital Status">
          <fieldset role="group" aria-labelledby="fsLegend101306076" id="label101306076">
            <legend id="fsLegend101306076" class="fsLabel fsRequiredLabel fsLabelVertical"><span>Marital Status<span class="fsRequiredMarker">*</span></span></legend>
            <div class="fieldset-content">
              <label class="fsOptionLabel vertical" for="field101306076_1"><input type="radio" id="field101306076_1" name="field101306076" value="Single" class="fsField fsRequired vertical" aria-required="true" disabled="disabled">Single</label>
              <label class="fsOptionLabel vertical" for="field101306076_2"><input type="radio" id="field101306076_2" name="field101306076" value="Married" class="fsField fsRequired vertical" aria-required="true" disabled="disabled">Married</label>
              <label class="fsOptionLabel vertical" for="field101306076_3"><input type="radio" id="field101306076_3" name="field101306076" value="Separated" class="fsField fsRequired vertical" aria-required="true"
                  disabled="disabled">Separated</label>
              <label class="fsOptionLabel vertical" for="field101306076_4"><input type="radio" id="field101306076_4" name="field101306076" value="Divorced" class="fsField fsRequired vertical" aria-required="true" disabled="disabled">Divorced</label>
              <label class="fsOptionLabel vertical" for="field101306076_5"><input type="radio" id="field101306076_5" name="field101306076" value="Domestic Partnership" class="fsField fsRequired vertical" aria-required="true"
                  disabled="disabled">Domestic Partnership</label>
              <label class="fsOptionLabel vertical" for="field101306076_6"><input type="radio" id="field101306076_6" name="field101306076" value="Widowed" class="fsField fsRequired vertical" aria-required="true" disabled="disabled">Widowed</label>
              <div class="vertical fs-clear">
                <label class="fsOptionLabel vertical" for="field101306076_other"><input type="radio" id="field101306076_other" name="field101306076" value="Other" class="fsField fsRequired" aria-required="true" disabled="disabled">Other:</label>
                <input type="text" id="field101306076_othervalue" name="field101306076_other" size="15" class="fsOtherField" aria-required="true" disabled=""><label class="fsHiddenLabel" style="display: none;" for="field101306076_othervalue">Other
                  Value</label>
              </div>
            </div>
          </fieldset>
        </div>
      </div>
      <div id="fsRow4102567-12" class="fsRow fsFieldRow fsLastRow">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101306456" lang="en" fs-field-type="number" fs-field-validation-name="How many children do you have?">
          <label id="label101306456" class="fsLabel fsRequiredLabel" for="field101306456">How many children do you have?<span class="fsRequiredMarker">*</span> </label>
          <input type="number" step="any" id="field101306456" name="field101306456" required="" class="fsField fsFormatNumber fsNumberDecimals-0 fsRequired" aria-required="true" disabled="disabled">
          <script>
            //This script is to address some quirkiness of Safari where commas are interchangeable with decimal points on number fields.
            //Normal attempts to restrict the comma such as our own validation or .replace(",", "") results in the value of the field being removed entirely.
            //Below the keypress itself is being blocked as a workaround to keep our value.
            document.getElementById("field101306456").addEventListener("keydown", function blockComma(e) {
              if (e.code === 'Comma') {
                e.preventDefault();
              }
            })
          </script>
        </div>
      </div>
      <div id="fsRow4102567-13" class="fsRow fsFieldRow fsLastRow">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101306466" lang="en" fs-field-type="text" fs-field-validation-name="Ages of child(ren)?">
          <label id="label101306466" class="fsLabel fsRequiredLabel" for="field101306466">Ages of child(ren)?<span class="fsRequiredMarker">*</span> </label>
          <input type="text" id="field101306466" name="field101306466" size="50" required="" value="" class="fsField fsFormatText fsRequired   " aria-required="true" disabled="disabled">
        </div>
      </div>
      <div id="fsRow4102567-14" class="fsRow fsFieldRow fsLastRow">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101306469" lang="en" fs-field-type="textarea"
          fs-field-validation-name="Please share a topic you'd like addressed (ex: discipline, substance misuse, relating to your adult child, etc.)">
          <label id="label101306469" class="fsLabel" for="field101306469">Please share a topic you'd like addressed (ex: discipline, substance misuse, relating to your adult child, etc.) </label>
          <textarea id="field101306469" class="fsField " name="field101306469" rows="10" cols="50" disabled="disabled"></textarea>
        </div>
      </div>
    </div>
    <div class="fsSection fs1Col" id="fsSection101306142">
      <div class="fsSectionHeader">
        <h2 class="fsSectionHeading">Confirmation </h2>
      </div>
      <div id="fsRow4102567-16" class="fsRow fsFieldRow fsLastRow">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell100505331" lang="en" fs-field-type="richtext" fs-field-validation-name="">
          <p><span style="font-size: 11px;">The Goal of Touching the Heart is to support you in navigating the challenges of your life. By enrolling in this program, you are giving us permission to connect with you via text and send you messages to
              say hello as well as sending tips for stress reduction and resilience.</span></p>
          <p><span style="font-size: 11px;">By signing up for Touching the Heart you are giving us permission to contact you via a text messaging services.</span></p>
          <p><span style="font-size: 11px;">You have the option to opt out of the program at any time by texting&nbsp;STOP to any message received from the Touching the Heart&nbsp;program.</span></p>
          <p><span style="font-size: 11px;">We want you to know that we take your privacy very seriously and&nbsp;we will not disclose your data to any third party for any purpose. Data collected is only used for the purposes of Touching&nbsp;the
              Heart and communication from Jewish Family Service.</span></p>
          <p><span style="font-size: 11px;">The Touching the Heart program is designed to a support to you but is not intended to manage a crisis situation. We recommend that if you are ever experiencing what you feel is a life-threatening emergency,
              that you first call 911 or the National Suicide Prevention Lifeline at 988.</span></p>
          <p><span style="font-size: 11px;">Thank you so much for becoming part of the Touching the Heart family. If you have any questions about the program, please reach out to us for more information.&nbsp;</span></p>
        </div>
      </div>
      <div id="fsRow4102567-17" class="fsRow fsFieldRow fsLastRow">
        <div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell100505461" lang="en" fs-field-type="radio" fs-field-validation-name="Do you agree to the Terms of Participation for Touching the Heart?">
          <fieldset role="group" aria-labelledby="fsLegend100505461" id="label100505461">
            <legend id="fsLegend100505461" class="fsLabel fsRequiredLabel fsLabelVertical"><span>Do you agree to the Terms of Participation for Touching the Heart?<span class="fsRequiredMarker">*</span></span></legend>
            <div class="fieldset-content">
              <label class="fsOptionLabel vertical" for="field100505461_1"><input type="radio" id="field100505461_1" name="field100505461" value="I agree to the Terms of Participation" class="fsField fsRequired vertical" aria-required="true">I agree
                to the Terms of Participation</label>
              <label class="fsOptionLabel vertical" for="field100505461_2"><input type="radio" id="field100505461_2" name="field100505461" value="I do not agree to the Terms of Participation" class="fsField fsRequired vertical" aria-required="true">I
                do not agree to the Terms of Participation</label>
            </div>
          </fieldset>
        </div>
      </div>
    </div>
  </div>
  <div id="fsSubmit4102567" class="fsSubmit fsPagination">
    <button type="button" id="fsPreviousButton4102567" class="fsPreviousButton" value="Previous Page" style="display:none;" aria-label="Previous"><span class="fsFull">Previous</span><span class="fsSlim">←</span></button>
    <button type="button" id="fsNextButton4102567" class="fsNextButton" value="Next Page" style="display:none;" aria-label="Next"><span class="fsFull">Next</span><span class="fsSlim">→</span></button>
    <input id="fsSubmitButton4102567" class="fsSubmitButton" style="" type="submit" value="Submit Form">
    <div class="clear"></div>
    <div class="withAds">
    </div>
  </div>
  <script type="text/javascript">
    window.FS_FIELD_DATA_4102567 = [];
  </script>
  <script type="text/javascript" src="//static.formstack.com/forms/js/3/jquery-3.5.1.min_dc5e7f18c8.js"></script>
  <script type="text/javascript" src="//static.formstack.com/forms/js/3/jquery-ui-1.12.1.min_d71fd11517.js"></script>
  <script type="text/javascript" src="//static.formstack.com/forms/js/3/scripts_0edcde2e8b.js"></script>
  <script type="text/javascript" src="//static.formstack.com/forms/js/3/analytics_7d49daa365.js"></script>
  <script type="text/javascript" src="//static.formstack.com/forms/js/3/libphonenumber-min_6f64debfdd.js"></script>
  <script type="text/javascript" src="//static.formstack.com/forms/js/3/modernizr_60a2d5aeb5.js"></script>
  <script type="text/javascript">
    (function() {
      var isLocalStorageSafe = true;
      try {
        if (typeof sessionStorage !== 'undefined' && sessionStorage.fsFonts) {
          document.documentElement.className = document.documentElement.className += ' wf-active';
        }
      } catch (e) {
        console.log('Failed to read from localStorage', e.message);
        isLocalStorageSafe = false;
      }
      var pre = document.createElement('link');
      pre.rel = 'preconnect';
      pre.href = 'https://fonts.googleapis.com/';
      pre.setAttribute('crossorigin', '');
      var s = document.getElementsByTagName('head')[0];
      s.appendChild(pre);
      var fontConfig = {
        google: {
          families: ['Lato:400,700']
        },
        timeout: 2000,
        active: function() {
          if (!isLocalStorageSafe || typeof sessionStorage === 'undefined') {
            return;
          }
          sessionStorage.fsFonts = true;
        }
      };
      if (typeof WebFont === 'undefined') {
        window.WebFontConfig = fontConfig;
        var wf = document.createElement('script');
        wf.type = 'text/javascript';
        wf.async = 'true';
        wf.src = ('https:' == document.location.protocol ? 'https' : 'http') + '://ajax.googleapis.com/ajax/libs/webfont/1/webfont.js';
        s.appendChild(wf);
      } else {
        WebFont.load(fontConfig);
      }
    })();
    if (window.addEventListener) {
      window.addEventListener('load', loadFormstack, false);
    } else if (window.attachEvent) {
      window.attachEvent('onload', loadFormstack);
    } else {
      loadFormstack();
    }

    function loadFormstack() {
      var form4102567 = new Formstack.Form(4102567, 'https://jewishfamilyservicesajivu.formstack.com/forms/');
      form4102567.checks.push({
        target: '100504509',
        action: 'Show',
        bool: 'OR',
        fields: ['100504475', '100504475', '100504475'],
        checks: [{
          field: '100504475',
          condition: '==',
          option: 'High School Student'
        }, {
          field: '100504475',
          condition: '==',
          option: 'Higher Education Student'
        }, {
          field: '100504475',
          condition: '==',
          option: 'Young Professional'
        }]
      });
      form4102567.checks.push({
        target: '101305991',
        action: 'Show',
        bool: 'AND',
        fields: ['100504475'],
        checks: [{
          field: '100504475',
          condition: '==',
          option: 'Parent'
        }]
      });
      form4102567.logicFields = ['100504475'];
      form4102567.calcFields = [];
      form4102567.dateCalcFields = [];
      form4102567.init();
      if (Formstack.Analytics) {
        form4102567.plugins.analytics = new Formstack.Analytics('https://jewishfamilyservicesajivu.formstack.com', 4102567, form4102567);
        form4102567.plugins.analytics.trackTouch();
        form4102567.plugins.analytics.trackBottleneck();
      }
      window.form4102567 = form4102567;
    };
  </script>
  <input name="fsUserAgent" id="fsUserAgent" type="hidden" value="Mozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/112.0.5615.121 Safari/537.36">
</form>

Name: email-formGET

<form id="email-form" name="email-form" data-name="Email Form" method="get" aria-label="newsletter signup"><label for="firstname-newsletter-2" labelfor="firstname-newsletter" class="field-label">First Name</label><input type="text"
    class="text-field w-input" maxlength="256" name="firstname-newsletter" data-name="firstname-newsletter" placeholder="" id="firstname-newsletter-2" required=""><label for="lastname-newsletter-2" labelfor="lastname-newsletter"
    class="field-label">Last Name</label><input type="text" class="text-field w-input" maxlength="256" name="lastname-newsletter" data-name="lastname-newsletter" placeholder="" id="lastname-newsletter-2" required=""><label for="I-am-interested-in"
    labelfor="lastname-newsletter" class="field-label">I am interested in...</label><select id="I-am-interested-in" name="I-am-interested-in" required="" data-name="I am interested in...." class="text-field w-select">
    <option value="">Select one...</option>
    <option value="General Interest">General Interest</option>
    <option value="BMHS">Behavioral &amp; Mental Health Services</option>
    <option value="Disability Services">Disability Services</option>
    <option value="Employment Services">Employment Services</option>
    <option value="Music + Spirit Program">Music &amp; Spirit Program</option>
    <option value="ReelAbilities">ReelAbilities</option>
    <option value="Volunteers">Volunteers</option>
  </select><label for="email-newsletter" labelfor="email-newsletter" class="field-label">Email</label><input type="email" class="text-field w-input" aria-required="true" maxlength="256" name="email-newsletter" data-name="email-newsletter"
    placeholder="" id="email-newsletter" required=""><label for="Phone-Number-Footer" labelfor="Phone-Number-Footer" class="field-label">Mobile Number</label><input type="tel" class="text-field w-input" aria-required="true" maxlength="256"
    name="Phone-Number-Footer" data-name="Phone Number Footer" placeholder="" id="Phone-Number-Footer"><input type="submit" value="Sign up" data-wait="Please wait..." id="newsletter-signup-button" role="button" class="submit-button w-button"></form>

Text Content

Click here to watch the Heart Full of Love Award Concert via livestream! For
more information visit HERE.

 * Services
   
   

Request Service
Donate
 * About Us
 * Resources & News
 * Houston Jewish Family Foundation
 * Shop Celebration Company
   

what are you searching for?

 * About Us
 * Leadership
 * Our Impact
 * Financials
 * Contact

Continually measuring our impact to improve the quality of our services.
Our Impact
 * Services
   Services
   
   
   
   
   Behavioral & Mental Health Services
   Licensed mental health professionals assist adults, adolescents, children and
   families to improve their overall well-being.
   Coaching & Case Management
   Providing individuals and families with access to information related to
   life’s challenges.
   Disability Services
   Enriching and empowering individuals with disabilities, their families and
   caregivers.
   The Career and Employment Center
   Vocational rehabilitation services, job counseling, assessment, placement and
   support.
   Jewish Chaplaincy
   Providing spiritual comfort and guidance for patients and their families.
   Explore all services
 * Services
   
   
 * Events
 * Get Involved
   
   
   
   
   Ways to Give
   Volunteer & Teen Opportunities
   Family Activities
   For the Good of Life Campaign

Request Service
Donate
 * About Us
   
   
   
   
   About Us
   Leadership
   Our Impact
   Financials
   Contact US
 * Resources & News
 * Houston Jewish Family Foundation
 * Shop Celebration Company
   
   

Request Service
Donate

Explore All Services
We offer a family of services that support and transform the lives of
individuals, families and communities.

Alexander JFS Services
Covid-19
See how Alexander JFS can help you deal with the impact of the pandemic.

Learn More

Behavioral & Mental Health Services
Licensed mental health professionals assist adults, adolescents, children and
families to improve their overall well-being.

Counseling
High-quality therapy for both adults and children.
AdultsChildren & TeensGrief & LossIntensive Outpatient ProgramSupport Groups /
Individual SessionsInsurance & FeesPay My Bill
Community intervention
Programs to raise awareness and knowledge.
PreventionWellnessMental Health First AidSources of StrengthSubstance
MisuseTouching the Heart
Professional Development
Continuing education for students and professionals in the mental health field.

Continuing Clinical Eduction  (CEU)Clinical Supervision & ConsultationPlay
Therapy TrainingClinical Internships
Community Request
Providing resources to communities affected by loss or trauma.
Continuing Clinical Eduction  (CEU)Clinical Supervision & ConsultationPlay
Therapy TrainingClinical Internships
Suicide Prevention


Coaching & Case Management
Providing individuals and families with access to information related to life’s
challenges.


Senior Adult
Helping seniors stay independent for as long as possible.
Direct ServicesSenior OutreachSenior Chavurot
Disaster Services
Guiding those impacted through a long-term recovery.

COVID-19Disaster PreparednessFlood AssistanceHurricane PrepardnessDisaster
Resources
Financial Stability
Providing classes and resources.
Student Loans & ScholarshipsCoaching and Financial Empowerment
Student Loan & Scholarship
Enim ullamcorper viverra hendrerit sed ut.
Family & Children
Helping parents and families address the root of challenges they experience.
Disability Case Management
Providing access to information, referrals and planning.
Holocaust Survivors

Disability Services
Enriching and empowering individuals with disabilities, their families and
caregivers.

Celebration Company
An entrepreneurial employment program for adults with disabilities.
About the Celebration CompanyAdmissions
Center for Art & Photography
Celebrating YouCelebration Company News
Shop Celebration Company
Community Programs
Focusing on inclusion and independence.
EmploymentSocial SupportTransition Aged Programs
Alexander Institue for Inclusion
Lowering stigmas related to people with disabilities.

About the InstituteCommunity Advocacy
ReelAbilities
disability Case Management
 Providing access to information, referrals and planning.

disability Resource Guide


Career & Employment Center
Guiding individuals through the job search process and providing qualified
applicants to employers.


Career Guidance for Professionals
Coaching and resources for job-seekers and those planning to change careers.
Employer Services
Strengthen your workforce with new talent and inclusion.
Career Guidance for Individuals with Barriers
A job counseling service to assist individuals with disabilities.
More
Contact Us
About Us
Pay my bill
staff

Chaplaincy
Providing spiritual comfort and guidance for patients and their families.

Career & Professional Development
Enim ullamcorper viverra hendrerit sed ut.
DIRECT SERVICES
Including home visits, family meetings, information and referrals.
COMMUNITY CONNECTIONS
Offering a variety of resources and information.
Local Synagogues
Jewish Organizations
Kosher Food and Restaurants
Temporary Housing
HOSPITAL PARTNERS
Serving the Texas Medical Center



WAYS TO GIVE



VOLUNTEER & TEEN OPPORTUNITIES



FAMILY ACTIVITIES



FOR THE GOOD OF LIFE CAMPAIGN



 * All Services
   
 * Behavioral & Mental Health Services
   
 * Community Intervention
   
 * Touching the Heart


TOUCHING THE HEART



Providing messages of support and well-being   

Joan and Stanford Alexander Jewish Family Service (JFS) offers this unique
text-messaging program that provides messages of support and well-being for high
school seniors through graduate school, as well as young professionals and
parents.

Research shows that friendly messages can support a sense of belonging and
overall wellbeing, ultimately helping to reduce isolation and prevent suicide in
this ever-changing world.  

Every two weeks, participants receive messages that help them stay grounded,
manage stress and navigate life challenges.

We currently have more than 150 active participants with a 90% retention rate.
People who join our program stick around because they feel the benefits. Whether
you are looking for support or are interested in offering it, we encourage you
to give it a try and sign up today.


Sign Up
Touching the heart gives:
 * A text message of support every two weeks
 * Wellness tips, inspiration and information for high school seniors, college
   and graduate students, young professionals and parents
 * An easy way to maintain resilience
 * An opportunity to text back and connect with a member of the TTH team
 * A free service for all in the respective age groups

Sign Up
Do you know someone who might benefit from encouraging and uplifting messages?
Let Us Reach Out




COMMON QUESTIONS ABOUT TOUCHING THE HEART

Who can sign up?



Anyone who is a high school senior, college student, graduate student, young
professionals or parent is welcome to join.


How much does this program cost?



This is a free service JFS Houston offers to the community.


What information do you need?



We ask for the receiver's cell phone number as well as some demographic
information for reporting purposes. The receiver can opt out at any time by
replying “STOP.”


What do the messages say?



Sample intro message: "Hi, Welcome to Touching the Heart! We are glad you joined
our text connection program. We'll be there with a few words of support every
two weeks to make your days a little easier. You can text back anytime if you
need additional support or have questions.
-Touching the Heart Team, Jewish Family Service Houston."


What are other things I can do to stay connected?



-Spend time writing in your journal. Identify your support system: friends,
family and other trusted adults who are there for you if you are struggling and
need to connect and feel safe and heard.

-Write about the healthy activities that leave you feeling restored and relaxed
and see if you can make the list longer each time you journal.

-Make time for connection with your friends and trusted adults every week.

-Tell someone you trust if you believe you would benefit from counseling.

-Consider writing the things you are grateful for and see how you feel.

-Keep a conversation going with your friends about how they are feeling

-Be sure you have had your annual physical and consider an annual counseling
“physical.”





UPCOMING EVENTS

Opportunities that transform lives - including yours.
View Calendar
Special!
May 5, 2023
9:00 AM - 4:00 PM
A Time for Play: Parent-Child Interaction Therapy Part 2: Parent Directed
Interventions
Event Details

Special!
May 19, 2023
9:00 AM - 4:00 PM
A Time for Play: Child Psychopharmacology
Event Details

Special!
June 2, 2023
9:00 AM - 12:00 PM
A Time for Play: Introduction to Play Therapy Supervision
Event Details






RESOURCES & NEWS

A central location for you to be empowered with knowledge.
Explore JFS Central
Behavioral and Mental Health
,

Supporting the Whole Family: Confronting Family Violence
Volunteers
,
Chaplaincy
Volunteers Needed: Shabbat Boxes
Carl’s Daily
,

Unplug, Rest and Reboot - March 5 2021
Agency News & Events
,

Welcome to JFSHouston.org
Disability Services
,
Disaster Services
Alexander JFS Joins Prepared4All Initiative from the Association of University
Centers on Disabilities (AUCD)
Behavioral and Mental Health
,
Disability Services
Be Well - Lessons in Special Needs Parenting
Celebration Company
,

Volunteer of the Month: Amy Powers
Behavioral and Mental Health
,

Self-Compassion Skills Group




SIGN UP TODAY

Please fill in a valid value for all required fields
Please ensure all values are in a proper format.
Are you sure you want to leave this form and resume later?
Are you sure you want to leave this form and resume later? If so, please enter a
password below to securely save your form.
Save and Resume Later
Save and get link
You must upload one of the following file types for the selected field:
There was an error displaying the form. Please copy and paste the embed code
again.
Apply Discount
You saved
with code
Submit Form
Submitting
Validating

There was an error initializing the payment processor on this form. Please
contact the form owner to correct this issue.
Please check the field:
Fields
Name*
First Name*
Last Name*

Age Range*
Under 18 18-24 24-30 30-40 40-50 50-60 60+
At what email address would you like to be contacted?
What phone number would you like to receive your Touching the Heart messages?*
What is your life phase?*
High School Student Higher Education Student Young Professional Parent
What is the name of your school or organization?
Zip Code*
What is your gender?*
Female Male Non-Binary Prefer not to say
Other: Other Value
What is your race or ethnicity? *
Asian Black or African American Hispanic or Latino Middle Eastern or North
African Multiracial or Multiethnic Native American or Alaska Native Native
Hawaiian or other Pacific Islander White
Other: Other Value


PARENT GROUP INFORMATION

Marital Status*
Single Married Separated Divorced Domestic Partnership Widowed
Other: Other Value
How many children do you have?*
Ages of child(ren)?*
Please share a topic you'd like addressed (ex: discipline, substance misuse,
relating to your adult child, etc.)


CONFIRMATION

The Goal of Touching the Heart is to support you in navigating the challenges of
your life. By enrolling in this program, you are giving us permission to connect
with you via text and send you messages to say hello as well as sending tips for
stress reduction and resilience.

By signing up for Touching the Heart you are giving us permission to contact you
via a text messaging services.

You have the option to opt out of the program at any time by texting STOP to any
message received from the Touching the Heart program.

We want you to know that we take your privacy very seriously and we will not
disclose your data to any third party for any purpose. Data collected is only
used for the purposes of Touching the Heart and communication from Jewish Family
Service.

The Touching the Heart program is designed to a support to you but is not
intended to manage a crisis situation. We recommend that if you are ever
experiencing what you feel is a life-threatening emergency, that you first call
911 or the National Suicide Prevention Lifeline at 988.

Thank you so much for becoming part of the Touching the Heart family. If you
have any questions about the program, please reach out to us for more
information. 

Do you agree to the Terms of Participation for Touching the Heart?*
I agree to the Terms of Participation I do not agree to the Terms of
Participation
Previous← Next→



Enter your save and resume password
Cancel
Confirm
Online Form - Touching the Heart Registration
Powered by Formstack

‍

Enrollment for this program is always open! Complete the Registration form and
start receiving occasional text messages with tips and just to say hello and see
how you are doing.



Contact Us Directly



(713) 986-7832

TTH@alexanderjfs.org

‍


Hours of Operation



Need Help Now?



If you feel that you are in an emergency, please reach out to these emergency
resources.

‍Call 911 or the 24 hour helpline at 713-970-7000 (option 1) or text "START" to
741-741.

Houston Crisis Hotline

1.866.970.4770

National Suicide Prevention Lifeline

988

suicidepreventionlifeline.org

The Trevor Project, LGBTQ Crisis Hotline

866-488-7386

National Domestic Violence Hotline:

‍1.800.799.SAFE (7233)
www.thehotline.org

For current Alexander JFS clients, please provide an update to your Alexander
JFS staff.

For clients who are seeking Alexander JFS services for the first time, please
inform the Alexander JFS staff about the recent care received through any
emergency resources. 









TOGETHER WE ARE STRONGER

Thank you to our collaborating partners and sponsors for providing essential
resources to make our work possible.


Partnership Opportunities


Volunteer
underwriter:

Label for logos:




WE PROVIDE LIGHT, HOPE AND HELP.



Explore Alexander JFS Services
Children's Counseling
A focus on the mental health and well being of children, ages 2 through teens.
Learn more
Mental Health First Aid
Trainings to learn a five-step action plan to recognize signs of mental health
distress in others.
Learn more
Support Alexander JFS
We rely on the gifts of many to deliver our services. Please consider being a
partner in our vital work.

Donate Now


Light

Hope

Help
Joan and Stanford Alexander
Jewish Family Service
4131 S Braeswood Blvd
Houston, TX 77025
Tax ID: 74-1152607
(O) 713-667-9336(F) (713) 667-3619(E) info@alexanderjfs.org
Follow Celebration Company
InstagramFacebook
Explore What We Do
CalendarAll ServicesBehavioral & Mental HealthCoaching & Case
ManagementDisabilityCareer & Employment CenterChaplaincyCareers at Alexander JFS
Support Our Work
Donate
Shop Celebration Company
Houston Jewish Family Foundation
ReelAbilities Festival
MediaContact
Follow Celebration Company
InstagramFacebook
Log On
BMHS Client PortalBoard Member PortalLeo Project Portal
Member of
Partner Agency of
Beneficiary of
Social services for Jewish Nazi victims have been supported by a grant from the
Conference on Jewish Material Claims Against Germany.

Family Matters E-News Signup
First NameLast NameI am interested in...Select one...General InterestBehavioral
& Mental Health ServicesDisability ServicesEmployment ServicesMusic & Spirit
ProgramReelAbilitiesVolunteersEmailMobile Number
Thank you!
Your submission has been received.
Something went wrong while submitting the form.
Member of NJHSA
Partner Agency of JFGH
Beneficiary of UWGH
Social services for Jewish Nazi victims have been supported by a grant from the
Conference on Jewish Material Claims Against Germany.
2020 Copyright
Accessibility StatementAnti Discrimination PolicyPrivacy Statement