Forms, Policies, and Helpful Links
Forms, Policies, & Helpful Links
Forms
Russell Mercier Senior Center- Registration Form
Everyone who participates in activities at the Russell Mercier Senior Center or attends trips sponsored by the Russell Mercier Senior Center, must complete this REGISTRATION form and return it to 12 Stonecroft Drive Hebron, CT 06248. Some programs (transportation, exercise, meals, exercise room, etc.) also require the FORM 5 to be completed.
“Help Us Find Your House in an Emergency” (Hebron Volunteer Fire Department Reflective Signs) Order Form
The Hebron Volunteer Fire Department will make a reflective sign with your house number on it, to aid them in finding your house in an emergency. Please complete this form and return it to the Hebron Fire Department, to order your sign.
“How to Alert 9-1-1 to Your Special Needs” If You Use AT&T Service
When a call is placed to the 9-1-1 alert center, the caller’s home address appears on the screen. Additionally, by filling out this form, the call center can be made aware of your special needs such as visual, auditory, and mobility impairment. By providing them with this information, they will be better able to assist you. Please print the form and return it to AT&T.
Policies
Town of Hebron Dial-a-Ride Guidelines
If you are looking to schedule transportation with us, reading these guidelines will give you additional information regarding when to call and schedule, the types of rides that we are able to provide, and to whom we are able to provide them.
Helpful Contact Information & Links
Long Term Care
Connecticut Long Term Care: Services & Supports –
This is a great resource to provide you easy access to comprehensive information on private and public long-term care (LTC) services and supports in Connecticut, including: Home Care, Community Care, Housing, and Institutional/Nursing Home Care, as well as information for caregivers.
Connecticut Partnership for Long Term Care –
860.418.6200
A collaboration between The State of Connecticut and private insurance companies, the Connecticut Partnership for Long Term Care provides Connecticut residents with unbiased information about the need for long-term care; the ability to find and purchase quality, affordable long-term care insurance; AND a way to get needed care without depleting assets.
Prescription Assistance & Insurance
Prescription Assistance & Insurance
Connecticut Insurance Department –
860.297.3900
The role of the Connecticut Insurance Department is to provide assistance and information to the public and to policy makers, by regulating the insurance industry in a fair and efficient manner, and to ensure fairness by enforcing the insurance laws.
Connecticut Department of Social Services: Pharmaceutical Assistance Contract to the Elderly & Disabled (ConnPACE) Application –
1.800.423.5026
This link will take you to the application for enrollment in the ConnPACE program, which helps eligible senior citizens and people with disabilities, afford the cost of most prescription medicines as well as insulin and insulin syringes.
Medicare –
1.800.633.4227
The Center for Medicare Advocacy –
860.456.7790
The Center for Medicare Advocacy, Inc. is a national non profit, non-partisan organization that provides education, advocacy, and legal assistance to help elders and people with disabilities obtain Medicare and necessary health care.
Housing
CT Housing Search –
1.877.428.8844
This housing locator service allows people to find available housing that best fits their needs.
Useful Resources
Useful Resources
Connnecticut Commission on Aging (COA) –
860.240.5200
The COA is an independent state agency devoted to enhancing the lives of older adults and promoting responsible public policy in preparation for an aging state and nation. The mission of the COA is to advocate on behalf of Connecticut’s present and future generations of older adults and to serve as an objective, credible source of information on issues affecting them.
Infoline –
2.1.1 or 1.800.203.1234
2-1-1 is a free community service. You can call 2-1-1 to get information, or to seek help in a crisis.
Benefits CheckUp: A Service of the National Council on Aging –
Check which programs you or your family members may be eligible for, based on your individual criteria and zip code, anywhere in the USA.
Social Security –
1.800.772.1213
Connecticut Department of Social Services –
1.800.842.1508
Programs for Elders –
1.800.443.9946
This website details general Department of Social Services’ programs that you may be eligible for as an older individual.
Aging Services Division –
1.866.218.6631
The Aging Services Division of DSS ensures that Connecticut’s elders have access to the supportive services necessary to live with dignity, security, and independence. They are an excellent resource for learning about the services that Connecticut has to offer.
North Central Area Agency on Aging –
860.724.6443
Serving 38 towns, including Hebron, in the North Central part of Connecticut, NCAAA is a regional non-profit organization that assists in the planning and organization of services to assist individuals in the aging population. Additionally, NCAAA obtains funding for towns, such as Hebron, to be distributed for programs such as Dial-a-Ride transportation and the AHM Youth Chore program.
For flu shot information: 1.888.668.6358