Is the patient in severe condition?
(Acute Care/Inpatient Services/ICU/PCU/NICU)
Does the family live at least 25 miles away from the hospital?
Is the family safe?
(No contagious diseases, non-threatening temperament/demeanor)
Provide a brochure to the family (or have them visit our Guest Page)
Jacob's House is FREE, no guest is turned away for being unable to pay. (Suggested Donation of $20/night)
If the family is interested:
Call us at 951-452-2627 to let us know you'll be submitting a referral
Complete the electronic referral form below
We will review the referral within 4 hours of receiving it. Referrals submitted after 8pm will be reviewed the following morning (9am).
JH Staff will call the primary guest for a brief phone interview
JH Staff will send a link to a registration form to the guest(s)
Jacob's House will only receive families between 8am and 8pm
(TO BE COMPLETED BY HOSPITAL STAFF ONLY)