Adult Day referalls

This section is intended for medical providers, case managers or social workers. If you are looking for information for you or a family member, please call our office at 320-281-4449

If you are a provider looking for more information on how to refer clients to our programs you will find information about referrals for each of our programs on the following pages:

If you are not a provider, but are seeking Adult day Services or a provider referral, please call your local County Department of Human Services

Eligibility

We accept BI waiver, AC program, CADI waiver, DD waiver, Elderly Waiver, ECS program, and private insurance.

Language

English (US)

WeCare Adult Day Referral

Adult Day Services
Client name*

First NameLast Name
Client status

New clientPrevious client
Email
Address*

Street Address

Street Address Line 2

CityState / Province

Zip Code
Mobile Phone
Home Phone
Transportation

Center TransportationOwn Transportation
Waiver Type*

CADIEWDDBI
DOB*

MonthDayYear
Ethnicity*
Disability*

YesNo
Type*

PhysicalMental IllnessDevelopmentalSubstance Use Disorder
Case Worker/Referall Source
Referred by*
Case Manager Name*

First NameLast Name
Case Worker Phone*

Area CodePhone Number
Case worker e-mail*
example@example.com
Reason for referral*
Services interested in*

Adult Day CareARMHSHousing Stabilization Services
Insurance Type*

Blue CrossUcareMedicaHealth Partners
Emergency contact
Relation to client
Contact number
Data protection*

Client understands and accepts that their information will be kept securely until it is no longer required to assist them or by law. Permission is granted to WeCare to contact the client by their identified preferred contact method.
Should be Empty:

WeCare Main Office

136 Division Street

Waite Park, Minnesota 56387

320-281-4449

WeCare Counseling and Housing Stabilization Services

110 2nd Street South, Unit 305 & 306

Waite Park, Minnesota, 56387

320-281-4454

WeCare Winona Office

350 Sarnia St E, Ste 4

Winona, Minnesota 55987

320-281-4383

Hours

Monday – Friday

8:00 am – 4:30 pm

Main Office: 136 Division Street, Waite Park, MN 56387 | info@wecaremn.org | Phone (320)-281-4449 | Fax (320)-281-4819

Adult Day Service referrals

Behavioral Health services referrals

Housing Stabilization referrals

PCA referrals

MNSure Navigation referrals

Statement of Non-discrimination

Adult Day Service Referrals

Eligibility

WeCare Adult Day Referral

Case Worker/Referall Source