Rep Payee Referrals

Guardian is open to the public by appointment only.
Please reach us during business hours, or for after-hours emergencies at:
Main Office 269.963.3253 | Toll-free (866) 963-3253 | Fax (269) 966-2485

BATTLE CREEK OFFICE
693 Capital Ave., SW, Unit #3, Battle Creek, MI 49015

KALAMAZOO OFFICE
2323 Gull Rd, Suite A, Kalamazoo, MI 49048
REPRESENTATIVE PAYEE

RERFERRAL FORM
Information of the Individual Making the Referral
Name of Person Referring*

First NameLast Name
Your Phone*

Area CodePhone Number
Your Email*
Agency you represent*
Why are you asking for us to serve as representative payee instead of a family member?*
Please give a brief description why there is a need for a representative payee: *

REPRESENTATIVE PAYEE