This page is for social workers, case managers, doctors, and nurses.
Guests cannot refer themselves.
How to Refer a Guest
STEP 1: Identify the Need
Is the patient in severe condition? (Inpatient Services)
Does the family live at least 25 miles away from the hospital?
Is the family safe? (No contagious diseases, non-threatening temperament or demeanor)
STEP 3: Contact Jacob's House
Call us at to let us know you'll be referring a family
Complete the electronic referral form
STEP 4: We will Review the Application
JH Staff will review the form within 2-4 hours
JH Staff will call the primary guest for a brief phone interview
JH Staff will provide a link to an electronic check-in/registration form to the guest(s)
Jacob's House will only receive families between 8am and 8pm
(TO BE COMPLETED BY HOSPITAL STAFF ONLY)