Make a Referral

Caring for a loved one with disabilities in the home can become an increasing challenge as the individual becomes older, stronger or, in some cases, their abilities continue to digress. Or perhaps the individual has a placement, but has either 'graduated' from that level of care, or, for whatever reason, is no longer appropriate for that service model. If you are disabled and feel you need a different type of support, if you are a case manager or social worker seeking alternative or first-time placement for one of your clients, or if you are a family member who just wants to see your loved one thrive in a way you know they can, give us a call.

• Update - Please take note: The State Intake Coordinator has returned from leave. Effective immediately, all referral-related business should again be routed through Leon Bohn, via any of the following:

   °   Email:  leon.bohn@thementornetwork.com
   °   Telephone:   (319) 393-1944   x23
   °   Fax:                (319) 393-2091
   °   US Mail:    REM Iowa – Attn: Leon Bohn
                            2205 Heritage Boulevard
                            Hiawatha, Iowa   52233

Already sure you'd like to apply for services? Download one of our Service Applications below and attach it to your email, or send it via Fax or US Mail.

Choose the Service Application that's right for you:

1. Service Application (MR/ID) - MS Word: This option allows you to complete the form directly on your computer. When complete, save the document to your desktop, then attach to your email. (For this type of Brain Injury application, click here.)
2. Service Application (MR/ID) - Adobe PDF: Use this option if you don't own a copy of Microsoft Word or would just prefer to fax or mail it to us in the traditional fashion. (For this type of Brain Injury application, click here.) (Don't have Adobe Reader? Download it for free here.)