Refer a Client

At Happy Home Health Care, we value the trust that case managers, healthcare providers, and family members place in us when referring clients for personal care assistance. We are committed to providing high-quality, compassionate care to help your clients or loved ones live comfortably and independently at home.

If you know someone who could benefit from our services, please fill out the referral form below. Our team will contact you or the referred individual promptly to begin the process of creating a personalized care plan.

Referrer Information

Name

First Name

Last Name

Phone Number

(###)

###

####

Email Address

Relationship to Client

Client Information

Client’s Full Name:

Client’s Phone Number:

(###)

###

####

Client’s Email Address:

Client’s Address:

Case Managers Name

Case Managers email:

PCA Hours Per Week:

Care Needs:

Additional Information (Optional)

Does the client have any specific requirements or medical conditions we should be aware of?

Preferred Start Date for Services:

MM

DD

YYYY

Why Refer to Us?

Extensive Background Checks: We ensure all of our Care workers undergo rigorous background checks and training to guarantee safety and professionalism.
Personalized Care Plans: Every client receives a customized care plan based on their individual needs and preferences.
Experienced, Compassionate Staff: Our Care workers are not only experienced but also compassionate and dedicated to improving the quality of life for those we serve.

Have Questions?

If you have any questions about the referral process or want more information about our services, please contact us at [phone number] or email us at karshe@happyhomeshealthcare.com.

We look forward to working with you to provide the best possible care for your clients or loved ones!

Who Can Make a Referral?

Case Managers
Healthcare Providers
Family Members
Social Workers
Community Organizations

How the Referral Process Works:

Submit the Referral Form: Fill out the form below with as much detail as possible about the client and their care needs.
Consultation: Once the referral is received, we will reach out to the client or their family to schedule a free consultation and assess their needs.
Care Plan Development: Our care coordinators will create a personalized care plan tailored to the client’s specific needs.
Begin Services: After approval of the care plan, we will match the client with one of our qualified Care workers, ensuring they receive compassionate, high-quality assistance.