Refer a Client

HOME HEALTH AND HOME CARE REFERRAL

Refer Someone for Support at Home

Use this form to begin a conversation about support from Registered Nurses, Licensed Practical Nurses, Home Health Aides or caregivers. You may refer yourself, a family member, a client or another person when you have the appropriate permission.

Prefer to speak with someone? Call 872-225-4999 or email Mokinshh@mhstaffings.com.

First name

Last name

phone number

Organization, if applicable

Reason for inquiry

Preferred contact method

Message

Consent

I agree that Mokins may contact me about this request by email, call or text.

What Happens Next

Referral review

The home health team reviews the referral and confirms that the location is within the Illinois service area.

Follow-up conversation

Mokins contacts the appropriate person to clarify the request and desired RN, LPN, HHA or caregiver support.

Verification

The team explains service availability, coverage verification and required intake steps.

Assessment and documentation

If appropriate, the client completes the necessary assessment and documents through the approved process.

Coverage and Payment Options

Mokins can review Medicaid, Humana, Blue Cross Blue Shield, CountyCare, Molina Healthcare, IDHS and private-pay information. Please contact the team to verify participation, eligibility, authorization and benefits for the specific service requested.

Does submitting the form guarantee services?

No. Mokins must review the request, Illinois location, service availability, eligibility, authorization and payment arrangements before services can begin. Do not upload detailed medical records to the public form; the team will explain how to share required documents securely.