Referral
The following website links have been compiled by American Home Health Care Resources. Our agency is not directly affiliated with these organizations however we have gathered this information as we believe they are all very useful agencies that can provide resources and assistance to you. Please visit their websites for more information on Medical Care.
If you would like our help navigating these websites or understanding the information please call today for an appointment 612-644-7600
- Personal Information
- Waiver Case Manager Information
- Level of Need
- Legal Status & Legal Representative Contact Information
Max. size: 128.0 MB
Please check the highlighted fields.
Please note, answering yes will not necessarily disqualify you.
Please provide below information or attach county referral form
For any of the following questions, if your answer is no – simply enter “Unknown” or “N/A” If yes, please explain.
- Part A
- Part B
- Part C
- Part D
- Part F
Max. size: 128.0 MB
Please upload the following documents to support your application. Each of these documents are required upon acceptance into Mn Corporate Housing’s programs. If you do not add it now, you will be able to add it later but this will delay your application in being processed. There will be an authorization to release information form to sign on the next page
Max. size: 128.0 MB
Max. size: 128.0 MB
Max. size: 128.0 MB
Max. size: 128.0 MB
Max. size: 128.0 MB
Max. size: 128.0 MB
Max. size: 128.0 MB
Please check the highlighted fields.