Refer Individuals or Families in Need

Do you know someone who is struggling and doesn’t know where to turn? Please have them reach out to us at 508 255-9667 or email If you would like to refer a client from your organization to HPC, please fill out the form below. 

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For a printable version of this form with mailing instructions, please click the button below. Forms can be faxed to the HPC office at (508) 255-4928.