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Our online form provides a quick and easy way for you those aged 65 and over to refer into the programme. 

The Local Coordinator will be in contact with all new participants to arrange a free home-based assessment visit.

The Local Coordinator will carry out a free home-based assessment and, in partnership with the older person, will identify and design a range of supports to enable the older person to continue living independently.  This will not affect any current home help, medical card, pension, or other services being received.

Please do not complete this form if you are already a participant of the programme/have been visited by a coordinator.  If you need another visit, please contact our national office on 046-9248899 to request same.