Furniture Assistance Referral 

Heart & Home Makeovers is pleased to help our neighbors in need have a home where they can thrive! This application is for assistance with furniture. Requests for furniture assistance require a referral from one of our approved partnering agencies. If your organization is one of our partner agencies, please answer the questions below to apply for furniture assistance on behalf of your client. If your organization is not an approved partner agency but would like to become one, you can apply here: Application for Agency Partnership

Submitting the application does not guarantee services. If the client is approved, assistance may take up to 3 months due to a wait list. For help with non-furniture household items like pillows, kitchenware, etc, the client can apply themselves by visiting our website. The wait-list for non-furniture assistance is typically 2-4 weeks. 
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Client's First & Last Name *
Client's Phone Number (include area code) *
Client's Email 
Your Name (This should be the Case Worker/Client Advocate) *
Your Email *
Your Phone Number *
Your Organization *
If you answered "OTHER" above, please give the name of your organization.
What is your role in the organization? *
Client's address (where furniture is needed). Include zip code and apartment number, if applicable *
Is your client currently living at the address listed above? If no, what is the move in date?
Client's household size (total number of people living in the home, including client) *
List the Name, Age and Gender of all household members
To qualify for our services the client must be employed or currently receiving disability benefits, although some exceptions can be made. Where is your client currently employed? If they aren't employed, are they working towards employment? Please explain their situation.  *
To receive services, a client must be experiencing physical, mental, and/or financial hardships. Please explain the hardship(s) your client is enduring so that we can understand why our services are needed.  *
How will furniture assistance positively impact your client?  *
Please explain the assistance your client needs from us (examples: they have no furniture in their 3 bedroom apartment, they have furniture but need beds for 2 children, etc) *
Since our services are provided at the client's place of residence, we have to be mindful of all safety concerns. Are you aware of any safety concerns with the home, the client, friends/family/neighbors, etc? Does the client have criminal charges or current VPO's against themselves or others? (DOES NOT disqualify a client from receiving services, it only helps us to plan and prepare accordingly.) *
As part of our process, we will reach out to your client and have them fill out a more detailed application. If we are able to help, we will notify your client directly. 
Is there any other information you would like to share or questions you may have?
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