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Get Connected - Contact Us!

"How Can We Connect You?"

Reasons to Contact us:

Food Box
  • Diapers, wipes

  • Clothing & furniture 

  • Food, formula assistance

  • Utilities assistance

  • Housing assistance

  • Domestic violence, dental, mental health & medical provider referrals

Kindergarten Guide
  • Low-cost licensed childcare centers

  • Low-cost licensed homes

  • Free Early Head Start childcare center (0-3 year olds)

Babies in Playroom
Expecting
Preschool Teacher and Students
  • Pregnancy support (WIC, MIHP, Early Head Start, 20 Hands) referrals

  • Age 3 Support (Early On) referrals

  • Low-cost centers,

  • Free Head Start classrooms (3-4 year olds)

  • Free GSRP classrooms (4 year olds)

Father and Daughter

Specific questions about your child's development. Please state the specific question you have in our "What is your Question" box at the top of the referral form.​

Baby with Stethoscope
Mother and Child
Learning the ABCs

Agency representative filling out form on behalf of family.

*Referrals for Early On and GSRP require additional authorization from parents in order for us to share information back to the referring agency. Please send this form (coming soon)

with parent's signature. to hmgallegan@alleganaesa.org.

Agency or caregiver updating family information in the system. 

Agencies making an

Early On or Build Up referral

for child with possible developmental delay(s).

Please list the following information in our "Referral Notes" box

at the top of the referral form.

  • Early On (age 0-3 years old) or Build Up (3-5 years old) referral

  • Specific reason for referral (i.e. communication, fine motor, gross motor, social, emotional, problem-solving concerns)

  • Best time of day we can contact you (Morning, Afternoon, Early Evening)

  • Any other information we should know about your family, like if your child had an IFSP or IEP.

Feel free to call us at (269) 512-7775

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