This referral form helps us learn more about you and what kind of support or connection may be the best fit. The more you share, the easier it is for us to identify meaningful matches. You can also upload a Person-Centered Plan if you have one.
Basic Information
Service Details
About the Individual
Ideal Provider or Connection
Additional Information
Please add me to the referral email list.
Disclaimers
I understand connections with providers cannot be guaranteed.*
Soaring Connections verifies provider status and references; however, does not endorse any provider. I understand individuals and guardians are responsible for confirming provider status, qualifications, training and references directly with DHHS DD through my service coordinator. *
Consent to Share Information
I authorize Soaring Connections to share my referral details for the purpose of helping individuals and providers connect. This may include posting limited information on Soaring Connections’ social media, in related community groups, and through provider email lists. I understand Soaring Connections will not share private contact info without permission and cannot control how information is used once shared. I may revoke this consent at any time in writing.*
