Help On Call
Social workers and medical professionals, please complete this form to refer a client to RSVP's Help on Call Program.

Help on Call is designed to assist low income (less than 300% of federal poverty level) seniors and disabled clients in Montgomery County with:
- rides to the doctor
- help with opening mail and paying bills
- friendly visiting or phone calls
- very minor repairs (changing light bulbs or batteries in smoke detectors, for example)
- shopping for the client (We do not take clients shopping)

Once this form is completed and submitted, you will receive a call or email to confirm receipt. We will also contact the client to tell them more about Help on Call and answer any questions. We will then add the client to our waiting list and look for a volunteer.

Please note that we have more requests for help then we do volunteers. This referral will remain active on file for six months. After six months, we will contact you for an update and to determine whether or not the client still needs assistance. We appreciate your patience and understanding.

If you have any questions, please contact:

Jane McGowan, Program Coordinator
janem@rsvpmc.org
610-834-1040 x138
Available Mon 9 am-4 pm; Tues 9 am-4 pm; Wed 1 pm-4 pm; Thur 9 am-12 pm
Your First Name *
Your answer
Your Last Name *
Your answer
Name of Your Agency *
Your answer
Phone Number, with extension *
Your answer
Email address *
Your answer
Your Street Address *
Your answer
Your City *
Your answer
Your Zip Code *
Your answer
Date of Your Intake *
MM
/
DD
/
YYYY
Have you meet with the client in person? *
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