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Human Resources Center, Inc.

Serving & Supporting Individuals with Disabilities in NEPA since 1973.

Home Based Services Referral Application

Date:

County Residence:

First Name

Last Name

Address:

Email

Phone

Date Of Birth:

Age:

Gender:

S.S #

MCI #

BSU#

Type of Service

Traditional Services

AWC/ FMS

OHCDS

Supports Coordinator

Supports Coordinator Supervisor

Supports Coordinator Agency:

Email

Email

Waiver Type

P/FDS

Consolidated

Community Living

Other

Contact Person

First Name

Last Name

Address

Phone

Email

Upload ISP File

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Thanks for registering. Please send copy of the current ISP to rebecca.berghoefer@hrcinc.org and shawn.chapman@hrcinc.org

About Us
Home & Community-Based Services
- Home Based Referral Application
Day Programming
- Prevocational Program
- Day Program
Employment Services
Residential Services
- Lifesharing
- Community Homes
Careers
- Current Job Openings
Contact Us
Photo Gallery
- 50th Anniversary Celebration
More

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Quick links

Residential Services

Employment Services

As part of our mission, The Human Resources Foundation provides long-term financial support to the programs and services of The Human Resources Center, Inc. Your donation to the foundation will directly support the work we do to help individuals and families in our area.

Human Resources Center, Inc. is an equal opportunity employer. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, sexual orientation, citizenship status, marital or veteran status. At HRC the Human Resources Department is dedicated to serving and meeting the needs of our employees. The Human Resources Department is in our corporate office at 294 Bethel School Rd. Honesdale Pa, and we are happy to answer any questions regarding our extensive employee benefit plan.

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