We would like to assist you in matching our services with your needs. Use the following questionnaire to help us evaluate your needs.
I am:
The Patient
A Caregiver
Other
The Patient
A Caregiver
Other
What is the age of the patient?
Infant to 17 years
18 to 50 years
50 years and older
Infant to 17 years
18 to 50 years
50 years and older
How can we be of assistance to you?
(check all that apply)
I, or the person I care for has/is:
| Diabetes |
Recovering from a wound |
| Paralysis |
Recovering from joint replacement surgery |
| Kidney failure |
Recovering from other surgery |
| A terminal illness |
Other |
How can we be of assistance to you?
(check all that apply)
I, or the person I care for needs:
| 24 hour care |
Someone to watch a child |
| Weekend care |
Grief counseling |
| "a break" |
Someone who speaks Spanish or another language |
| Someone to administer medications |
Housekeeping services |
| Physical therapy |
Someone to sit with a loved one |
| To switch caregiver services |
Someone at home when I get out of the hospital |
| Other |
How can we be of assistance to you?
(check all that apply)
I, or the person I care for has/is:
| Difficulty controlling bladder |
Trouble walking, standing |
| Hard of hearing |
Trouble with endurance, standing, sitting |
| Difficulty seeing |
Trouble eating |
| Paralysis |
Problems with balance |
| Trouble moving fingers and hands |
Other |
We have these programs that will fit your general needs. To learn more follow the links below.
For more information, please Contact Us.
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Welcome To The World of Access
Home Care - Hospice Care - Private Duty
ACCESS is a full service home health care provider. We will provide the service that is appropriate for you. We pride ourselves in providing individualized care plans to more fully meet your needs. Our promise to you is simply:
“We will work with you to ensure 100% satisfaction. We know our care makes a difference and we invite you to 'feel the difference' too."
