Agency Referral

Ready to refer a child to Welcome Home Angel?

Mission

Our mission is to bring joy to children with significant health or life altering conditions and relief to their families by creating happier and more functional living spaces.

What We Do

Welcome Home Angel serves families with children who have chronic illness, physically debilitating injuries, or significant developmental disabilities who are restricted by limitations in the following areas of major life activity: self-care, mobility, and capacity for independent living.

We renovate their bedroom (and sometimes other living spaces, depending upon need). Many renovations are primarily aesthetic to enrich the environment where the child spends so much time and calls their own, but other renovations are major, to include door widening, handicap accessible bathrooms, and ramps. We also do a minor makeover in sibling rooms so they don’t feel left out. We tend to work with families who own permanent residences, but we will consider a family who rents, on a case by case basis.

We respect the privacy and confidentiality of all information that we receive about each family, whether we accept their case or not. All cases must be approved by the Welcome Home Angel Board of Directors.

How it Works

  1. Identify a child that you think might benefit from the services of Welcome Home Angel. The child must: a) be 4-18 years old; b) be in New Hanover, Pender, or Brunswick Counties; c) live in a home that is owned by the parent/guardian of the child or is a long-term rental.
  2. You, the agency representative, notify the family that you would like to refer them and obtain their permission for release of the information on this form.
  3. Complete this form.
  4. Welcome Home Angel will then send the family an application and perform due diligence, upon receipt of the application and supplemental documentation. If child is qualified, WHA staff will perform a home visit.
  5. After the home visit, and upon approval, a child is put on the WHA Wait List. The family will be contacted once a Design Team is assigned to their case. Please do not guarantee WHA services to the family or suggest a timeline for the approval and completion of their case.
  6. Once a Design Team is assigned to a case, the process of providing the family with a new environment for the child and a minor makeover for the siblings will begin. Welcome Home Angel will be involved in every step of the process to ensure that the family is able to maintain safe conditions for their child during the renovation.

Please complete the entire form - do not leave blanks.

CHILD'S INFORMATION

Gender
MaleFemale

Is the child currently hospitalized?
YesNo

FAMILY'S INFORMATION

With whom does the child live?
MotherFatherGrandparent(s)GuardianOther

Home is...
OwnedRentedShared with OthersOther

AGENCY INFORMATION



CONFIRMATION