Health Services

Health Referral Form

Please use this form to refer clients within your organization to our health classes and child wellness programs. Our team responds based on urgency level.

Eligibility Requirements

Before submitting, please ensure your client meets our requirements:

  • •Female of refugee/immigrant status
  • •Reside in New Haven County or Connecticut
  • •Predominantly speak Arabic, Pashto, Dari, or Farsi

Medical Emergency?

This referral form is for non-emergency health navigation only.

If this is a life-threatening emergency, call 911 immediately.

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Organization of Origin

Referee Information

Help Center

Frequently Asked Questions

Who is eligible for health services?

We serve female refugees and immigrants residing in Connecticut who predominantly speak Arabic, Pashto, Dari, or Farsi.

How quickly will you respond?

Emergency referrals: 1-2 hours. Moderate: 24 hours. Routine: 48 hours.

Are services free?

Yes, all our health navigation and education services are completely free.

Do you provide interpretation?

Yes, professional interpretation is provided for all health education sessions.