Make a Referral

Referrals

Refer someone for Support Services

WellHealth Services accepts referrals for individuals who may benefit from our Housing Stabilization Services (HSS) or 245D Waiver Services. Whether someone needs help finding and keeping stable housing or support with daily living and community-based care, you can securely submit their information using the form below.

We accept referrals from:
  • Case managers

  • Family members

  • Healthcare providers

  • Or the individuals themselves

Eligibility Requirements:
  • Age 18 or older

  • Enrolled in Medical Assistance (MA)

  • Experiencing housing instability or at risk of losing housing

Our team will review the referral and follow up promptly. All submissions are handled with care and in compliance with HIPAA regulations.

WELLHEALTH SERVICES

REFERRAL FORM

Eligibility (Required)

* Must be 18+ years

* Actively on Medical Assistance

* Experiencing or in danger of housing stability?

Need help completing the form?

We’re happy to assist. Call us at (952) 923-4174 or email referrals@wellhealthservices.org, and someone from our team will support you.

Prefer to Submit Offline?

You can download our referral form, fill it out, and send it to us by email.

📄 Download Referral Form PDF
📧 Email to: referrals@wellhealthservices.org

Frequently Asked Questions