Professional Referral Form

A referral to First Link® and our many programs and services will save you valuable time and energy.

Whether you are a healthcare professional or a community support agency (police, ambulance, fire, etc), it’s simple. Complete our online form, or fax us the completed Referral Form, and our First Link® team will take care of the rest.

Your clients or the individuals you ar ehelping will receive:

  • Telephone contact offering an opportunity to meet with one of our First Link Care Navigators for a phone, virtual, in-office or in-home assessment to determine individual and family needs and work on an individualized plan of care.
  • An opportunity to participate in a variety of education and support groups, as well as social recreation programs (a client assessment is required prior) geared towards those in the early to mid stages of dementia.
  • Information about Alzheimer’s disease and other dementias.
  • Linkages to appropriate community services.

Prefer to fax?

If you’d prefer to fax a referral form to Alzheimer Society Southwest Partners, please download our fillable form.

Impact testimonials

Quick Links to our available support programs and information:

Skip to content