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Dementia Referral Form

RNC Operational Updates for Monday, July 15, through Friday, July 19

The Milwaukee County Courthouse will remain open during the Republican National Convention (RNC). All court operations (Civil and Family Filings, Restraining Orders, Probate, In Custody Intake Court, Preliminary Hearings) will be operating at Vel Phillips Juvenile Justice Center (10201 W. Watertown Plank Rd. Wauwatosa, WI.) For more information about how other Milwaukee County services and operations will be impacted during the RNC, visit Milwaukee County's RNC updates webpage.  

Dementia Care Specialist Referral Form

If an individual or a caregiver expresses concern about memory loss, dementia or Alzheimer’s, complete this referral form to connect them to our services. Upon receiving this referral, a dementia care specialist from Milwaukee County will contact them. 

The Dementia Care Specialists (DCS) with the Aging and Disability Resource Center of Milwaukee County focus on supporting people with dementia and their caregivers/families to ensure the highest quality of life possible while living at home. Dementia Care Specialists work with people and family members on a voluntary basis.

Please do not fill out a Dementia Care Specialist referral form if:

  • You need crisis services
    • If this is a medical emergency, please call 911.
    • If you are contacting to report or provide an update on a matter of abuse, neglect or financial exploitation or guardianship please submit a referral online.
  • The person with dementia lives in a care facility like an assisted living or nursing home
    • Connect with the dementia lead or nursing lead at the facility.
  • The person with dementia is enrolled in a Long Term Care Program (Family Care, IRIS, PACE, Partnership)
    • Connect with the dementia lead in their Long Term Care Program.


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Referral Source

If this is a referral, please provide your contact information for any follow-up questions.



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