Seniors at Home.

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Home Safety Application – Apply Now

We are excited to announce that we recently received a small grant to help Madison County seniors living at home! We will be using this grant to help Madison County senior residents make small modifications to their homes to keep them safe and help them to age in place.

A few modifications could make your home easier and safer to live in as you live independently. Common needs for those aging in place may include, but not limited to installing grab bars, shower bars, improved lighting, etc.

Please fill out the application below and click the submit button to apply. If you would prefer to fill out the form by hand, please click here to view the printable version. Printed forms may be returned by US Mail, email or dropped off in person. If you have questions or would like more information, please contact Linda Harshman by calling 765-298-6444.

If you have questions or would like more information, please contact Linda Harshman by calling 765-298-6444.

Contact Information

Home Safety Application for Madison County Residents

Name

Address

City, State, Zip

Phone

Email Address

Are you age 60 or older?

Do you rent your home?

Do you have a financial hardship?

Are your needs temporary or permanent?

Will you allow a licensed therapist to evaluate your need?

Are you the homeowner and occupy the house?

Notes: Please include any other information you would like to include in order to be chosen for this grant.

Please return printed forms to:
Essential Senior Connections
800 N Central Ave, Alexandria, IN 46001 Attn: Linda Harshman
linda.harshman@eshl.org

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