Call Or Text Us: (610) 492-6632

Tell us about the person needing home care services. There are 5 questions total in this survey and will take less than 5 minutes to complete. You will be able to schedule your assessment once submitted.

First Name *

Last Name *

Email *

Phone *

What is their current age? *Please note we are only serving clients over the age of 18 *

0 - 18 years

18 - 65 years

65+

Address

Street Address *

City *

State *

Postal Code *

3. Home care services are typically private pay. Are you planning to pay privately, use Veteran's Assistance Benefits, or long-term care insurance? *

Private pay

Veteran's Assistance

Long-term care insurance

I don't have the financial means to pay for services

4. When are you hoping to begin services? *

Immediately

Within 1 – 2 weeks

Within a month

Just exploring options

5. Is there anything else you’d like us to know about your situation? *

Compassionate Care. Right Where You Belong.

Serving families throughout Southeastern Pennsylvania:

No Place Like Home Care is a Registered Non-Skilled Home Care Agency licensed by the Pennsylvania Department of Health under License No. HC-XXXXXX.

To report a consumer complaint or concern, contact the PA DOH Home Health Hotline: 1-800-254-5164