This form is for adults who are age 60 and older and who have been residents of Allegan County for at least 60 days, and who would like to request services provided by the senior millage. Staffing challenges are currently increasing the wait time for some services.  Submitting this form will start the referral process. Once received, our team will review your request to determine eligibility.  After eligibility has been established, the referral will be assigned to one of our service providers.  Once staffing has been identified, you will be contacted to schedule an intake and assessment.  All referrals are processed in the order they were received.

Online Senior Referral Form