Refer Someone
Please select one of the following options:
Please note these forms are not for Utility Assistance or Home Weatherization services, those request must go through the CEAP phone line: 713-956-7456.
Choose the Professional Referral Form to request non-medical care services (excluding utility assistance or weatherization), if you are a medical professional, discharge planner, or other care professional.
Choose the Home Health Care Referral Form to request nursing and rehabilitation services, if you are a physician, discharge planner, or other care professional.
Choose the Individual Referral Form if you are referring a family member or friend.
For Utility Assistance, please call 713-956-7456.
For Home Weatherization services, please call 713-956-1888.
Thank you for your referral!