Hospital Staff

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 or life-threatening 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 2: Educate the Family

  • 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:

STEP 3: Contact Jacob's House

  • Call us at 951-452-2627 to let us know you'll be referring a family

  • Complete the electronic referral form below

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

REFERRAL FORM

(TO BE COMPLETED BY HOSPITAL STAFF ONLY)

PAPER/FAX FORM (Backup use only)

Download Form

Fax #

951-790-0869