Make a Referral

NOTICE: ISAC is experiencing a significant increase in requests for assistance. As a result, it is taking staff longer than normal to return calls and respond to referrals. We triage based of need and circumstance. Thank you for your patience.

Make a Referral

Client Information
Is the client currently living in Allegheny County, and do they fall into one of these categories: 1) Immigrants, 2) Children of immigrants, 3) Individuals from US territories, 4) US citizens born and raised outside of the continental states?*
- Yes
- No
ISAC can only serve individuals who reside in Allegheny County with a language or cultural barrier who fall into one of the following categories: immigrants, children of immigrants, individuals from US territories, US citizens born and raised outside of the continental United States.

Those who do not meet these requirements should call United Way at 2-1-1 or the Community COVID Hotline at 412-422-0400 to be directed to the appropriate services.
Is the client in need of immigration legal services ONLY?*
- Yes
- No
If the client is seeking immigration legal assistance ONLY, please fill out this form for JFCS Immigration Legal Services Department. Click here for form.
If the client needs additional services, please check "No" in the box above and complete the referral.
Name*
First Middle Last
Phone Number*
Other Phone Number
Email
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of Birth
MM slash DD slash YYYY
Country Of Origin (Place Of Birth)*
Language(s) Spoken*
Does the client need interpretation? (Please only select one answer)*
- Yes
- No
What language does client need interpreted?*
Reason for Referral & other relevant information. Please be specific and describe what services or resources the client needs connected to and any barriers experienced in doing so: (Ex: Client needs urgent medical care, clients has food at home, etc)*
Referral Source
For this section, please explain who the referring party is - whether it is an provider, self-referral, family or friend.
Referred By:*
Name*
First Last
Organization*
Relationship to Client

ESL teacher, medical provider, etc
I received permission from the client to submit this referral.*
- Yes
- No
Phone Number*
Email*
Comments
This field is for validation purposes and should be left unchanged.

Please note, the client will receive a call back in the order referrals are received unless referral is indicated as an emergency. Referring parties will not be contacted unless further information is needed.

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Disclaimers:

ISAC is not a crisis intervention service. If you or someone you know is experiencing an emergency, please call 911.

ISAC provides interpretation for its clients according to language access requirements of Title VI of the Civil Rights Act. ISAC is not an interpretation service and does not provide interpretation for non-ISAC staff.

Make a Referral

Client Information

Referral Source

Please note, the client will receive a call back in the order referrals are received unless referral is indicated as an emergency. Referring parties will not be contacted unless further information is needed.

We will communicate with you in your language

ISAC Partners

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