The referral form below is for individuals to be screened for the CCSP Program in the Atlanta region.

Please complete all fields with the red asterisk; otherwise, the referral will not be successfully submitted.

Help three ways

Your needs come first. How can we help you? Call now, open a chat window, or leave a message for us to contact you later.

Help three ways

Your needs come first. How can we help you? Call now, open a chat window, or leave a message for us to contact you later.

Looking for the latest guidance on the Covid-19 virus?

The CDC has created this video: “Covid019: What Older Adults Need to Know.”  You can also read CDC’s full list of pandemic-related recommendations.

If you are looking to connect with resources and services for older persons and individuals and disabilities in metro Atlanta, please contact us at empowerline.org or 404-463-3333.