Apply for Services
To Submit Documents by Mail or Email:
1826 W. Broadway Rd., Ste. 16
Mesa, AZ 85202
Safe at Home
If you are in need of fall prevention home modification services (grab bars, bathroom assistance devices, a wheelchair ramp, etc.) please review the information on the Safe at Home program page.
Click below for a printable application or submit a request by email. If you do not have access to email or a computer, please call 480-774-0237 to have an application mailed to you.
If you are in need of critical repairs (roofing, plumbing, etc), please complete the appropriate applications below in orange.
Gilbert Critical Repair
If you are in need of critical repair services (flooring, plumbing, roofing, etc.) and live in the Town of Gilbert, please print the application below.