Submit Senior Well-Being Check Request Request


Reporter (leave blank to submit anonymously)

Enter as 999-999-9999

Senior Well-Being Check Request

This service request is used to identify seniors whose health, safety or general well being are in question. The City will send a team of Human Services specialists to make a assessment of the client's needs. Follow-up services can be identified and provided as needed.

Instructions

Describe the issue you wish to report including a photo and/or a description.
* Indicates a required field.