Referrals

Refer a client to Karma Home Care

We welcome referrals from individuals, families, caregivers, case managers, care coordinators, social workers, and other referral partners.

Complete the form below and our team will contact you to discuss the individual's needs and next steps. Fields marked with an asterisk are required.

Individual being referred

First name

Last name

Date of birth

Phone

Address

City

ZIP code

Referral source

Tell us who you are so we know who to follow up with.

Your name

Organization / agency

Relationship to individual For example: daughter, case manager, social worker.

Phone

Service requested

Which service is this referral for?

Choose as many as apply. If you are not sure, choose “Not sure / Help me choose”.

Respite Care 24-Hour Emergency Assistance Companion Services Homemaker Services Night Supervision Individualized Home Supports Without Training Not sure / Help me choose

Payment

How will services be paid for?

Private pay Other / contact me

Medicaid / Medical Assistance — coming soon

Enrollment is currently pending, so Medical Assistance cannot be accepted yet. Choose “Other / contact me” and we'll share the latest enrollment information.

Tell us how we can help

Briefly describe the individual's support needs

Preferred start date

Best time to contactFor example: weekday mornings.

Submitting a referral does not guarantee acceptance or establish a care relationship. Our team will review the referral and contact the appropriate person regarding availability and next steps. Please share only the information needed for us to follow up.

Prefer to call?

You can reach our team directly.

(619) 317-8316

Secondary: (612) 408-4241
Karmacare2025@gmail.com

What happens next

We review the referral.
We contact the person you've listed as the referral source.
We talk through needs, availability and next steps.

Not for emergencies

This form is not monitored around the clock. In a life-threatening emergency, call 911.