Free Assessment Tool
Please fill out this form if there is someone you believe will benefit from our services or that you are referring to Plan to Protect.
Thank you so much for the referral. If your referral results in a sale, we will thank you with a $10 coffee card. If your referral results in a membership we will provide you a bundle of 10 on-line training registrations (value $200).
Name of Your Organization
Please do NOT use acronyms, please spell out your organization's name.
Your Phone Number
Please do NOT use acronyms, please spell out the organization's name.
Referral's Organization Type
Please choose one
Church/Place of Worship
Nursing Home for the Elderly or Vulnerable Adults
Refugee Centre / Constituent Group
If other, please describe.
Referral's Phone Number
What segment of the vulnerable sector do they serve?
Individuals with Disabilities
Refugees and/or New Immigrants
What did you discuss about Plan to Protect®?
Have you already mentioned us to them?
No, not yet
Suggested steps for follow up:
Phone call from Plan to Protect®
Email from Plan to Protect®
Client will contact Plan to Protect®
Thank You so much!