# Referral Partner Quarterly Check-in Template

Use this agenda when calling a hospital social worker, discharge planner, senior center coordinator, case manager, faith-community leader, or community organization that may refer families to your home care agency.

## Partner details

- Partner organization:
- Contact name:
- Role/title:
- Phone/email:
- Last outreach date:
- Last referral received:
- Next scheduled touch:

## Opening script

Hello [Name], this is [Your Name] from [Agency]. I wanted to check in briefly, thank you for the families you have sent our way, and make sure we are still supporting your clients in the way your team expects.

## 1. Review the last three referrals

| Date | Family/context | Outcome | Follow-up needed |
|---|---|---|---|
| | | | |
| | | | |
| | | | |

Prompts:

- Did we respond quickly enough?
- Was the handoff easy for your team?
- Was there any confusion about service scope, pricing, availability, or eligibility?
- Is there a client type you wish we supported more clearly?

## 2. Ask what they are seeing now

Use these questions to understand current demand:

1. Are you seeing more families needing post-hospital support, dementia help, respite, transportation, or personal care?
2. Are families asking for shorter shifts, longer shifts, weekend coverage, or rapid-start help?
3. Are there care situations your team struggles to place?
4. What would make our agency easier to refer to?

## 3. Clarify referral expectations

Confirm the preferred process:

- Best person for your team to contact:
- Best way to send referrals:
- Information they prefer to include:
- Expected callback time:
- Whether outcome updates are helpful:

## 4. Offer a useful next step

Choose one:

- Send a one-page service summary.
- Drop off updated brochures.
- Schedule a short team introduction.
- Send a direct intake phone/email route.
- Share a simple checklist for families preparing for care.

## 5. Closing script

Thank you for taking the time. We will keep the process simple: when you send a family, we will capture the care need, respond quickly, and keep the next step visible. I will follow up on [date] with [specific item].

## Follow-up record

- What we promised:
- Who owns it:
- Due date:
- Next outreach date:
- Relationship status: Active / Warm / Dormant / Needs repair