Take the first step to join the ICP family today.

Please complete the form to begin the process of becoming an ICP client. If you would prefer to mail the form via the postal service, you can download the Intake Form and mail it to us at:

Interfaith Community Partners
111 West Harris Avenue
La Grange, IL 60525

Fields marked with an * are required



Emergency Contact Information

In consideration for assisting me in obtaining transportation to and from my appointments, I hereby waive and release Interfaith Community Partners’ officers, director, board members, employees and volunteers from any and all liability with respect to said transportation and the arrangement for said transportation and agree to hold harmless each of them for claims arising from these services. NOTE: Interfaith Community Partners volunteers are unable to provide any physical assistance to our care partners.

ICP volunteers are unable to provide any physical assistance to our Care Partners.