Client Application - Agewell Home Care

Client Application

Get the personalized home care you need. Our 8-step assessment helps us understand your specific requirements and match you with the perfect caregiver.

Step 01

You

Let's start with your contact information.

Who should we call?
Best number for a quick call or text.
Accepts US, international, and various formats
We'll send your written plan here.
Step 02

Who needs care

Tell us about the person who will receive care.

Who needs care?
Adults 18+.
For service area and travel time.
So we match the right caregiver.
Step 03

Daily needs (ADLs)

Let us know what daily assistance is needed.

Check what help is needed.
Step 04

Safety flags

Help us understand any special safety considerations.

Helps us staff safely.
Step 05

Schedule intent

Help us understand your care schedule preferences.

We recommend 20+ hrs/week for steady coverage.
Minimum visit is 4 hours.
Pick all that apply.
When do you want to begin?
Step 06

Coming home from hospital?

Help us understand if this care is related to a recent hospital stay.

Are we starting after a hospital or rehab stay?
Step 07

Insurance

Help us understand your insurance coverage.

If you have a policy, we'll help you use it.
Step 08

Contact window

Let us know the best way to reach you.

We'll aim for this window.
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Non-medical home care. 4-hour visit minimum. Pricing shown may adjust after a quick home safety check.