Request for Senior Services

To report Elder Abuse or Neglect, call our hotline at 1-800-734-2020 24hrs/day.
Do not complete our online form.

How do I Request Services?

There are 2 ways to request services: 

What Type of Services Can I Request?

Referral sources can request the following type of services for a Consumer: Information, Home Delivered Meals, In-home Services, Adult Day Services, Caregiver Support, Ombudsman, Long Term Care Facilities, or OTHER.

What Information is Required?

When you request services from the Montgomery County Office of Senior Services, we require the following information:

  • Name, complete address and phone number of consumer and spouse
  • Date of birth, consumer SSN 
  • Living arrangements, marital status, names and phone numbers of contact person(s), physician, demographic information, etc.
  • Reason for referral; type(s) of service(s) being requested
  • Medical diagnosis, including cognitive status
  • Ability to perform tasks such as bathing, dressing, preparation of meals, etc.
  • Information on income and assets for consumer and spouse

We will be able to process your request when we obtain the above information.

Please allow time for staff to follow-up as we receive a large volume of calls and requests daily. We appreciate your cooperation and look forward to working with you. Feel free to call 610-278-3601 if you have any questions.