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IDSGT Wellness Call Sign-up Form

Introducing the IDSGT Foundation Wellness Call Program - a simple way to stay connected and support older adults.

Whether you're a family member, neighbor, caregiver, or community partner, you can request a wellness call for someone who may benefit from regular check-ins and friendly conversation.

Our trained volunteers provide consistent outreach to help reduce isolation, offer emotional support, and ensure seniors feel seen, heard, and cared for.

You can also request updates for added peace of mind about your loved one’s well-being.

Getting started is easy! Just complete the form below, and our team will follow up to confirm the details.

REQUESTER'S INFORMATION
Please enter the information for the person/agency making the request.

Name

Email Address Phone Number

What is your relationship with the senior?

SENIOR'S INFORMATION

All information submitted is kept confidential and will not be shared without your consent.
Information is only shared when necessary to connect clients with additional services such as rent or utility assistance, and only with permission.

Name

What language do they speak?

What type of phone do they have?

What type of phone do they have?

City and State when client is located

How often would you like us to contact them?

How often would you like us to contact them?
A
B
C
D

If other, please state below

What's the best time of day to reach them?

When would you like for the calls to start?

Any concerns

Any concerns

If other, please state:

Details of request:

Please list anything that would be helpful when making contact. If nothing, type "N/A

I certify that I have permission to supply the information above, and give the I Did Something Good Today Foundation permission to contact me and the person listed above.

I certify that I have permission to supply the information above, and give the I Did Something Good Today Foundation permission to contact me and the person listed above.