Make a Referral

Good Neighbor Senior Advocates provides independent senior advocacy and family support services. If you know an older adult or family who could benefit from compassionate, unbiased guidance and support, please use the form below to make a referral.

We welcome referrals from families, healthcare professionals, senior living communities, attorneys, and community organizations. While we collaborate with professionals and care providers, our responsibility is always to the individuals and families we serve. We remain independent so that our guidance and advocacy are centered on each client's needs, preferences, and best interests.

Who can refer?

We welcome referrals from:

Healthcare professionals
Hospital discharge planners
Social workers and case managers
Physicians and medical practices
Rehabilitation and skilled nursing facilities
Assisted living and senior living communities
Home care agencies
Hospice and palliative care professionals
Care managers and care coordinators
Mental and behavioral health professionals
Elder law attorneys and other legal professionals
Senior centers and community organizations
Churches, clergy, and faith-based organizations
Family members and caregivers
Friends and neighbors
Guardians
Agents acting under a power of attorney
Other authorized representatives

Why refer to us?

Referring someone to Good Neighbor Senior Advocates connects individuals and families with compassionate, independent support focused on their unique needs, preferences, and choices. We help navigate care options, communicate with providers, understand available resources, and make informed decisions with greater confidence and peace of mind.

For professionals and community partners, a referral builds a trusted relationship with an independent, unbiased advocacy resource. While we collaborate with providers and organizations, our responsibility remains with the individuals and families we serve, ensuring that their voice, choices, and best interests remain at the center of our advocacy.

Submit a referral

Your Name *

Organization / Relationship to Individual *

Your Email

Your Phone Number

Name of Person Being Referred *

Preferred Contact Person (if different)

Contact Phone Number *

Contact Email

Relationship of contact person to Individual

Reason for Referral/ How Can We Help? *

Preferred Method of Contact *

Phone
Email

Best time to Contact *

Morning — 8:00 AM–12:00 PM
Afternoon — 12:00 PM–4:00 PM
Evening — 4:00 PM–7:00 PM
No preference / Anytime

Additional Information

I confirm that the individual or their authorized representative is aware of this referral and has given permission for their contact information to be shared with Good Neighbor Senior Advocates *

I confirm

Please do not submit medical records, Social Security numbers, insurance information, financial account information, or other sensitive health or financial information through this form.

Our commitment to you

Every referral is approached with compassion, respect, and individualized attention. Our advocacy remains centered on the needs, preferences, voice, and choices of the individuals and families we serve