Refuge House Application


  1. Click here to fill out Housing Application  If you don't have access to a desktop computer or need assistance with the application, please email

  2. Please save the completed application and email it as an attachment to - OR - Print the completed application and mail it to Refuge House, PO Box 241524 Milwaukee, WI 53224 - OR - Fax the completed application to 414-797-4011.

  3. Make an appointment to see your physician and see him/her as soon as possible.

  4. Click here for Physician Forms Take these 5 pages to your next doctor’s appointment or email them to your physician.

  5. The following 4 tests need to be done at your doctor’s appointment or scheduled at a lab. Your doctor’s office will fax your completed test results directly to Refuge House.

  • TB

  • HIV

  • STI testing/history

  • Basic drug panel

We will schedule a meeting with you to review your application as soon as we receive your portion of the application, the physician’s portion of the application and the test results.

A Place of Refuge Ministries of South WI, Inc. is a 501(c)3 non-profit corporationand a Recognized Service Organization of the Lutheran Church-Missouri Synod. EIN: 39-1971929

©2013-2020 A Place of Refuge Ministries of South Wisconsin, Inc.

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Pregnancy Hotline:

(414) 476-6333

Blessed Again Resale: 

7624 W. Hampton Avenue
Milwaukee, WI  53218
(414) 464-9099

Office Phone:

(414) 438-2767