Request Services

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Request Services

Tell us about the nonmedical support you or someone you care for is seeking. We’ll follow up to discuss service fit, availability, scheduling, and payment options.

What to expect

Share the basics

Your name, contact information, county, general service interests, and a preferred way to reach you.

We’ll connect

We will discuss needs, preferences, location, timing, and next steps. An inquiry does not guarantee service availability.

Review payment

Ask about Private Pay or Long-Term Care Insurance. Policy coverage and reimbursement depend on the carrier and the individual plan.

Protect your privacy: Please do not include medical records, Social Security numbers, policy numbers, or other sensitive information in an initial website inquiry.

Service inquiry

Use this page to request services for yourself or a family member. Professionals can use the separate referral pathway.

Name
Best number for a callback.
Briefly describe the nonmedical help needed. Please do not include medical records or sensitive details.
Marion, Hamilton, Hancock, Hendricks, Boone, Johnson, Morgan, or Madison County.
How do you expect to pay?
Permission to contact you

Are you a professional partner?

Use the referral pathway for discharge planning, care management, legal, or community referrals.