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Service Request Form

Welcome to Heart of the Valley, SERVICES FOR SENIORS, Inc. We help seniors 62 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!

Fields marked with an * are required

Services Requested

Your request has been submitted

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