Request a Bed

All clients needing beds will need to be referred by an advocate. The advocate must complete the form to register their client. Examples of advocates are:

  1. A Social Worker
  2. A Social Service Agency Representative
  3. A Teacher
  4. A School Counselor
  5. A Healthcare worker

If you need assistance finding an advocate or a social service agency please call 211 on your phone for United Way to help with an agency referral.

Please have your advocate fill out the form completely or the request may not be able to be processed.

  • Important: Texting is the primary communication method. Please make sure the phone number entered in the Client Mobile Phone field is a valid number and monitored for texts.
  • Social Service Agency

  • Bed Request

  • *Texting is primary communication method
  • Use the + button to add bed requests for the family.
    Sleepyhead Beds provides beds for children and their families. If there are children in the home, we will help all the adults and kids within the home.
    AgeM/FEthnicityBed Type 
  • This field is for validation purposes and should be left unchanged.