top of page

Referral Form


Do you know someone who is pregnant? Do they have little or no support from the baby’s father, family, or friends? We are here to help. Send us their name and number, and we’ll speak with them about the support available from Bridge and other service providers. Simply fill out the form below, and we’ll contact them!

This form is NOT for social workers or case managers to refer a client for material assistance.

May Bridge Mention You Made Referral?

Thanks for submitting!


Are you a social worker that has a mother or family with a child two and under that needs our help? Email us to receive Bridge’s Social Worker Packet so you have the forms necessary to refer your client.

Include your name, agency name, phone number and extension (if applicable) and work email. If this is your first packet request also include your agency’s address. All first packet requests are verified prior to emailing out the social worker packet.

Come See Us

147-32 Sanford Avenue, 2nd Floor
Flushing, NY 11355

Phone: (718) 463-1810
Call or text: (516) 387-2055
Fax: (718) 463-1813

Material Assistance
Phone: (718) 463-1821

Office Hours*

Closed Sunday & Monday
Tuesday - Friday: 11am - 5pm
Saturday 9am - 1pm

*Please call before coming in to drop off any donations.

bottom of page