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Getting Started
Getting Started
1
Who
2
Where
3
Care For
4
Insurance
5
Timeframe
6
Contact Info
Who is in need of care?
*
Infant (0-2)
Child (3-18)
Adult Female (19-64)
Adult Male (19-64)
Senior (65+)
Choose the person who needs Lend A Hand to continue to the next step.
Name of person needing care?
*
Please enter the person's name.
Where will they need to receive homecare?
*
Hartford County
New Haven County
Fairfield County
Middlesex County
Tolland County
None of the Above
Lend A Hand provides care in the home, nursing facilitites and hospitals.
Do they need care for any of the following?
*
An Accident (e.g., fall, injury, etc)
Chronic Pain
Asthma
Heart Disease
Alzheimer's Disease/Dementia
Diabetes
Pulmonary Disease
Hospice Care
Stroke/Other Brain Injury
Cancer
High Blood Pressure
None of the Above/Not Sure
(check ALL that apply)
What type of health insurance do they have or is eligble for?
*
Private Insurance (e.g., Aetna, BlueCross BlueShield)
Out-of-pocket (private pay)
Medicaid
Medicare
None
Not Sure
How quickly will care need to begin?
*
Immediately (within 24-48 hours)
This week
This month
Not sure
Email
*
Let us know how we can contact you.
