Senior Companion Program - Client Referral Survey



To receive services from the Senior Companion Program, clients must FIRST meet the following criteria:

  1. Must be at least 60 years of age
  2. Must live in Bradford, Sullivan, Susquehanna, or Tioga County
  3. Must need some assistance to maintain independent living in their homes


The BSST AAA Senior Companion staff can receive client referrals through the following sources:

  • From the staff at Volunteer Stations, referring individuals attending who will benefit from a Senior Companion on site (after gaining agreement from client)
  • Directly from the client requesting a Senior Companion
  • From Care Managers or other AAA programs already providing services to the client (after gaining agreement from client)
  • Family members, friends, neighbors, etc. can make a referral for the client (after gaining agreement from client)
  • Other Healthcare or Caregiver referrals (after gaining agreement from client)


1. Follow instructions on the link below for the New Client Referral Form,

            a) Complete the Form,

           b) Print and mail to BSST AAA Senior Companion Program at 220 Main Street,

                Unit 2, Towanda, PA, 18848, or,

            c) Save completed form and Email to

2. Request Care Manager or other Agency Services to submit a Client Referral to the Senior Companion Program for those they are providing services. (See step #1 above).

3. Call the BSST AAA office at 1-800-982-4346 (8:00 – 4:30), asking for the SCP staff to respond to Senior Companion Program New Client Referral Survey.

4. Contact the leadership staff at the Volunteer Station to assist in preparing a New Client Referral Form (see step #1 above).

Client Referral Survey