Apply for Services
Solicitar Servicios
All Applications
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To Submit Documents by Mail or Email:
1826 W. Broadway Rd., Ste. 16
Mesa, AZ 85202
480-774-0237
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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.
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Central Phoenix Critical Repair
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If you are in need of critical repair services (flooring, plumbing, roofing, etc.) and live in the following zip codes you may be eligible 85003, 85004, 85006, 85007, 85008, 85009, or 85034.