Follow the steps to fill out the form online.

1. Use the ‘Get Form’ button to obtain the referral form and open it in your preferred PDF viewer.
2. Begin by filling in the personal details of the individual being referred, including their first name, last name, and date of birth.
3. Specify the gender and pronouns of the person being referred, along with optional information about their sexual orientation.
4. Provide contact details, including phone number and email address. Make sure the information is accurate to ensure proper communication.
5. Complete the address section with the current residence of the individual, ensuring all fields are filled out correctly.
6. Indicate whether the individual permits the Peer Navigator program to contact them via phone or text message by checking the appropriate boxes.
7. In the section regarding primary needs, select the most relevant options related to health and wellness or income and finances.
8. Detail the supports the individual currently has, selecting from the provided list, and include any other supports under the 'Other' category.
9. Clarify the current housing situation by marking the relevant boxes corresponding to the living conditions of the individual.
10. Identify the types of income the individual receives, noting any relevant categories that apply, including options for no income.
11. Add any additional notes or comments in the designated section, which can be helpful for understanding the individual's situation.
12. Fill in the information of the person or organization making the referral, including their name, contact info, and relationship to the individual.
13. Once all sections are completed, review the form for accuracy. You can then save changes, download, print, or share the completed form as needed.

Take the next step toward connecting with vital resources by completing and submitting the referral form online.