Make a Referral

Do you know someone who could benefit from a Texas Healthy at Home class? Whether you are a friend, relative or health professional, making a referral is easy. When you refer someone for a class, they will be contacted by someone who can answer any questions and help them register for the class.

Please fill out the form completely. For more information about Texas Healthy at Home classes, please email us at


Information of Person Being Referred

Information of Person Offering the Referral

I have read the THAH Privacy Policy and Terms of Use and I have obtained consent from the person I am referring to submit this referral on their behalf.