Partner referrals
Connect an adult with Serenity Nest. Fields marked with an asterisk are required.
Tell us who is making this referral.
For privacy, please provide only the client’s last initial.
Select every option that applies.
Select every option that may support housing costs.
Confirm each statement before submitting.
Answer each question so we can determine whether independent living is an appropriate fit.
Serenity Nest provides structured independent living. We do not provide medical care, skilled nursing, personal-care assistance, medication administration, or 24-hour supervision.
Please do not include Social Security numbers, identity documents, full addresses, or detailed medical records in this form.
