Forms • I-Team Referral

I-Team Referral

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If this is an emergency or someone is in immediate danger, please call 911. This referral form is used to share concerns related to possible abuse, neglect, self-neglect, or exploitation of adults within Williams County. The information you provide will be reviewed by the Williams County Adult Interdisciplinary Team (I-Team)—a collaborative group of professionals dedicated to improving safety, care, and outcomes for vulnerable adults. Please complete all applicable fields below to help the I-Team assess the situation and determine how best to provide support.
Your Contact Information
First Name
Last Name
Phone Number


Details of the Referred Individual
First Name
Last Name
Street Address
City
State
Zip
Phone Number
Name of Caregiver (if any)
Please list any partner agencies you are already working with (if any)


Please provide a summary of the situation or issue prompting this referral. Include relevant observations, concerns, or any background information that may help the I-Team assess the case.



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