How to Make a Referral to HHUNY
HHUNY is accepting referrals from the community (health care providers, community organizations, individuals and/or family members) for enrollment of eligible individuals into HHUNY Health Home Care Management Services.
Complete one of the online forms below including as much detail as possible to allow HHUNY to verify eligibility for health home care management services.
Self-Referral: If you’re submitting a referral on behalf of yourself or a family member
Community Referral: If you’re an agency, health care provider or community organization and submitting a referral on behalf of someone in the community
Please click on attachment A to view the list of agencies and organizations that your information may be disclosed to, only when necessary for your referral to be processed.
Attachment A for Central Region
Attachment A for Finger Lakes Region
Attachment A for Southern Tier Region
Attachment A for Western Region
Other Options for Making a Referral to HHUNY
Download the referral and consent form for your region and send via secure e-mail or fax, or mail to:
Tracy Marchese, HHUNY Community Referral Coordinator
Email: referrals@hhuny.org
Fax: 585-613-7670
Mail: Community Referral Coordinator
HHUNY
1150 University Ave, Suite 142A
Rochester, NY 14607
Central Region
- Referral Form
- Fillable Referral Form
- Spanish Referral Form
- Burmese Referral Form
- Karen Referral Form
Finger Lakes Region
- Referral Form
- Fillable Referral Form
- Spanish Referral Form
- Burmese Referral Form
- Karen Referral Form
Southern Tier Region
- Referral Form
- Fillable Referral Form
- Spanish Referral Form
- Burmese Referral Form
- Karen Referral Form
Western Region
