Request home support
For older adults or families who need direct help, companionship, or guidance with care coordination.
Apply for support
One application path for in-home support, advocacy, and wellness education.
Use this form to request support across any of our service areas. You can apply for yourself or on behalf of someone else, and we will follow up with the right next steps.
Before you apply
- You can apply for yourself or on behalf of someone else
- Use the form even if you are unsure which program fits best
- Urgent needs can be explained in the notes field
Application tracks
What kinds of support can be requested.
Request wellness education
For seniors, caregivers, staff, volunteers, or community groups interested in infection prevention, healthy eating, chronic disease prevention, personal safety, or wellness workshops.
Request accessibility support
For households navigating mobility, safety, or disability-related challenges within the home.
Request transition or advocacy support
For individuals or families needing help with community resources, healthcare navigation, social supports, or transitions to retirement or long-term care.
What to prepare
Simple information helps us route support faster.
- Basic contact details for the applicant or family representative
- A short description of the current need or challenge
- Location and availability information for follow-up
- Any urgent safety, mobility, or access issues we should know about
What happens next
We aim to respond within two business days.
We review your intake and identify the right program or support pathway.
A team member follows up to clarify needs, timing, and fit.
If another partner is better placed to help, we point you there quickly.
When appropriate, we begin service planning, orientation, or a referral package.
Take the next step
Tell us what support is needed.
Use this intake form for home support, decluttering, lawn care, companionship, transition help, advocacy, or wellness education.
- You can apply for yourself or on behalf of a family member
- Choose the support area that feels closest to your need
- We will review your submission and follow up within two business days