Wake Independence at Home Adult Day Funds

SPEED REFERRAL
for Wake Independence at Home Adult Day Funds
FAX: 919-872-6683

This form is intended to facilitate the referral process that you, as a professional, are undertaking on behalf of your client. You may print it, fill it out, and fax it to us, or you may fill it out and email it to us. If you are unsure of eligibility requirements, you have an obligation to call RFS at 919-872-7933 to speak to an Intake Specialist. We cannot screen your clients through this form!

For the cost-share programs, your client must be a resident of Wake County, 18+ years of age, and have personal care needs, NOT just housekeeping/meal prep. An Intake specialist, at the above number, can assist you in screening your client if you are unsure whether yours would be an appropriate referral.