Partner Referral

Partner Referral Steps

1

Step 1: Send

Send the person you are referring the Client Intake Form and encourage them to complete it.

2

Step 2: Submit

Complete the Partner Referral Request below to refer an individual or family to Love
INC for support.

3

Step 3: Connect

The Client Services Team will contact the referring partner to gather any additional information needed.

4

Step 4: Collaborate

Love INC and the referring partner collaborate with the client to provide support with dignity and love through an established action plan.

Person Being Referred:

Name(Required)

First Last

Phone(Required)

Email(Required)

How long have you known this person?(Required)

Please provide insight into the person's current situation and needs.(Required)

List any assistance already provided.(Required)

What areas do you see for growth (spiritual, relational, emotional, or physical)?(Required)

Referring Partner Organization

Partner Contact Person / Liaison Name(Required)

First Last

Title / Position with Partner(Required)

Phone(Required)

Email(Required)

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