Service Request Form

Welcome to Heart of the Valley, SERVICES FOR SENIORS, Inc. We help seniors 65 yrs. or older in our West Santa Clara County service area. If you’d like to check if you are in our service area, please check your eligibility here.

If you are not familiar with the services and programs we provide, you might wish to learn more about our Services and Programs.

If you are ready to request some assistance, please fill out the form below. Remember we need at least 7 days working days notice, so that we can look for a volunteer to help you.

Once we receive your request, we will be in touch. Thank you!

Please note that due to COVID-19, Heart of the Valley’s office will be temporarily closed until further notice. However, Heart of the Valley is offering four services to seniors, 65 yrs. or older in our service area or volunteers interested in helping them.  These services are a friendly caller, technology help over the phone, no-contact yard work, and no-contact household hazardous waste(HHW) pickups.  If you are interested in one of these services, please either telephone (408) 241-1571 or email us at contact@servicesforseniors.org, and leave your name, phone number, and a brief description of your need.  We will get back to you as soon as we can. Thank you!

Fields marked with an * are required

arrow&v
Services Requested

Your request has been submitted