⏰ Give60 is July 7 - 9th! Your gift helps provide wheelchair ramps, fall prevention services, weatherization, and more for local residents. Visit our Donate page to give.

Additional menu

Enable Madison County

Supporting aging and homebound neighbors across Madison County.

DONATE
VOLUNTEER
SERVICES
MORE INFORMATION

Requesting Services

Access programs and services that help aging and homebound residents in Madison County.

Taking the First Step Toward Services

Enable Madison County provides programs and services that help aging and homebound residents of all ages remain safe and independent at home. Complete the form below to request information, referrals, or support services. After submission, an intake coordinator will review your request and contact you to discuss next steps, eligibility, and available resources. Submission of this form does not guarantee services.

REQUEST SERVICES

Service Request Form

Full Name *

Phone Number *

I am completing this form as *

The individual needing services (resident)
A caregiver, family member, or representative

Resident Name *

Service Address *

Resident lives in Madison County, Alabama *

At least one of the following must be selected: *

Resident is age 60 or older
Resident is homebound

Service Request *

Wheelchair Ramp
Grab Bars or Handrails
TEMP$ Weatherization
Not Sure

Please describe the need *

Referral Source

I give permission for Enable Madison County to contact me regarding this request. *

(256) 533-7775 info@enablemadisoncounty.org 701 Andrew Jackson Way NE, Huntsville, AL 35801

}