Make a Comforts of Home Referral

Thank you for referring your client to UWNEMN's Comforts of Home program!

This program is currently closed to in-person appointments due to the COVID-19 pandemic, but our staff is available to pack items for you to pick up on your client's behalf. Upon filling out this form, our staff will contact you with additional details, including an inventory of available items your client can use to build a list of requested items. (Please note, requested items are not guaranteed as multiple pick-up appointments are often made concurrently.)

If your client would prefer an in-person appointment, please indicate such when describing their need, and we will make a note to reach back out when it is safe to have guests in our building again. 
UWNEMN's Comforts of Home program is meant to be a one-time use program. 

If your client has mitigating circumstances, please contact to discuss further. 

Case Manager Contact Information

Client Information

Number of Adults in Household
Number of Children in Household

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