A support professional listening to an adult she supports on a porch, both smiling.

Request services

Tell us what you need. We will tell you plainly what we can do.

This is a short first contact form, not an intake packet. A few details are enough for us to reach you and start the conversation.

About you

Who is making this request?

Your name

Phone number

Needed if you want us to call or text you.

Email address

Needed if you want us to reply by email.

Preferred contact method

Phone call Text message Email

About the person needing support

Just the basics. Nothing medical, and nothing about a diagnosis.

Their name

A first name or initials is enough. If the request is for yourself, use your own name.

Their age range

City or county

Where support would be provided. No street address needed.

What you are looking for

Service you are interested in

Type of support you are looking for

How are services funded?

Please do not send Medicaid IDs, case numbers or plan documents. "Not sure yet" is a fine answer.

Anything you would like to add (optional)

A sentence or two about what you are looking for. Please do not include medical records, diagnoses or other sensitive health information.

What happens next

1

You send this form

A name, a way to reach you, where you are, and what you are looking for. Nothing medical.
2

We contact you

Someone from Helping Hands reaches out the way you asked, to talk through your needs and the next steps.
3

We plan it together

If we are a fit, we work with the person, the family and the service coordinator to build a plan that reflects real goals.

A note on privacy

Please do not send diagnoses, medical records, Social Security numbers, Medicaid IDs or detailed behavioral histories through this form. If that information is ever needed, we will use a secure process for it.

If we are not the right fit, or your request falls outside what we are authorized to provide, we will tell you that directly.

Prefer to call?

Phone

(503) 451-3645

info@helpinghandsor.com

You do not need to know exactly what to ask for. Tell us the situation, and we will tell you honestly whether we are the right fit.

What you can expect

Get in touch

Not ready to submit a form?

Call or write to us with a few details and we will point you the right way.

No medical details needed: A few sentences is enough to start.
Straight answers: We say so if we are not the right fit.

Call us directly

(503) 451-3645

Request services Contact us