Skip to content
Help For Dementia Logo
Support

FirstLink Referral

Supporting someone living with dementia can be both deeply rewarding and challenging, often changing from moment to moment. Ensuring that care partners take time for their own well-being is equally important.

The Alzheimer Society of Alberta and Northwest Territories accepts referrals from family members, friends, community members and healthcare providers to ensure care partners receive the assistance they need.

help@alzheimer.ab.ca
1-866-950-5465

Charity registration number:
12969-0343 RR0001

"*" indicates required fields

If you or someone you know is seeking support, please complete the form below. (All information in this form is secured and not shared.)

Who is filling out this form?*

Person Making the Referral

How Urgent is this Referral?*
Do You have Consent to Make this Referral?*
Who is Being Referred?*
Tell us who this referral is for. Choose whether the person being referred is the person living with dementia or a care partner or family member.

Person Being Referred

Is it okay for us to leave a phone message for the person being referred at the phone number provided?*
Use this space to share anything else you would like us to know about the person being referred or the support you are looking for.

We want to ensure you feel supported. Do you want help in your preferred language or with any cultural or spiritual considerations that are important to the person being referred?