Anyone concerned with a patient’s well-being can make a referral. Whether a family member, physician, clergy member, friend, associate, or a person in need of care yourself, all you need to do is fill out the form below. Information will, of course, be kept private and confidential. Your E-mail is only for acknowledgement purposes. After submitting this information, Haven Health will contact the patient and assess what care best suits him or her within one day.