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WNY Adult Health Home Community Referral Application Fax: 7163320075Fax: 7168321271Fax: 7162784565Fax: 5856137670Fax: 5856137670Choose the Health Home agency you would like your referral to go to:
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Gather personal information such as name, address, and date of birth.
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Provide details about your health insurance, including the provider and policy number.
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Document your medical history, including any chronic conditions and past treatments.
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List all current medications and dosages.
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Adults who require help navigating the healthcare system.
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Individuals experiencing mental health challenges that affect their physical health.
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WNY Adult Health Home is a coordinated care model designed to provide comprehensive health services to individuals with chronic health conditions, ensuring they receive necessary medical and supportive care.
Individuals living in the Western New York region who meet the eligibility criteria for health home services, including those with chronic illnesses or behavioral health conditions, are required to file for WNY Adult Health Home.
To fill out the WNY Adult Health Home application, individuals should gather required documentation, complete the application form accurately, and submit it to the designated health home provider in their region.
The purpose of WNY Adult Health Home is to coordinate care for individuals with multiple health needs, improve health outcomes, and enhance accessibility to services while promoting individual participation in their health care.
Information that must be reported includes personal identification details, health history, current medications, and contact information for health care providers involved in the individual's care.
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