How to Enroll in the Day Program 

To enroll in the Day Program, please follow the steps below. Once we receive the application forms and the medical report from your primary care doctor, we will schedule an interview with our Clinical Manager/Caregiver Specialist.

1. Complete the 2-part application (Demographics & Health History and Personal History), add your family member's name to the file name when you save it (for example, Demographics & Health History - Pat Jones), and email the files to

2. Download the HOW Medical Report and ask your family member's primary care doctor to fax it to HOW at 847.242.6275 (this is required before your family member can start attending).


Enrollment forms can be filled out electronically or downloaded to your computer and filled out by hand. To use the fillable forms electronically, download and save them to your computer or tablet. After the forms are filled out, email them to If you fill out the forms by hand, please print legibly. Forms may be mailed or dropped off at HOW during business hours. 

1.  Demographics & Health History 

     Personal History.

2. HOW Medical Report