Helpful Information & Tools
In The Spotlight
Homecare Assessment Request Form
To best satisfy you or your loved one's needs, Senior Options Homecare has developed a systematic approach to evaluating, monitoring and documenting the many aspects of our professional homecare services. Part of this process includes our complimentary initial homecare needs assessment. We take the time too truly understand your specific needs and to match our professional caregivers with you or loved ones.

This homecare needs assessment includes:
  • A one-on-one meeting with one of our care managers to assess you or your loved ones health and living conditions, including scheduling of medical exams, medication management, food supply and quality, driving and transportation, personal grooming and emotional state, household cleanliness, security measures, social outings and life activities.
  • Preparation of a confidential written assessment and detailed plan.
  • Discussion and approval of care-giving agreement.
Please complete our homecare assessment form that follows and click on the submit button. Once we receive your form, one of our care managers will contact you to schedule your complimentary homecare assessment. If you prefer not to submit your information over the internet, please contact our office directly at 616.942.5380 to schedule a time to meet or to obtain additional information.

First Name Last Name
Address
City State Zipcode
Home Phone Work Phone
Fax Email
Requesting Services For
Service Request: Include contact name, phone number and service description, e.g. escorted transportation, cleaning, shopping, and anything else you would want us to know
How did you hear about Senior Options Homecare?
May we send Senior Options Homecare information to a family member, friend or colleague?
First Name Last Name
Address
City State Zipcode
Relationship