Client Referral Form
Submit referrals for clients who need furniture and household items
Online Form Coming Soon
We’re currently updating our online referral form to better serve our partner agencies. In the meantime, please email your referrals directly to our agency relations team.
Before You Submit
Your agency must be registered with Furniture Assist before submitting referrals. If you are not yet a partner agency, please visit our Agency Registration page to get started. For details on the full referral process, visit the Referral Process page.
When emailing your referral, please include the following information:
- Client name and agency contact information
- Referring agency name and your contact information
- Household size and number of children in household
- Items needed — furniture, kitchenware, clothing, etc.
- Any special circumstances we should be aware of
Submit a Referral
Email your completed referral form or referral details to our agency relations team. Please allow up to two weeks for appointment confirmation.