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Proximity Care —
Free
Assessment Request
After your free assessment, eligible families receive their
first 6 hours of care completely free.
Your Name
*
Phone Number
*
Email Address
*
City
*
Who needs care?
*
Who needs care?
A
My parent
B
My spouse
C
Myself
D
Other
Which care plan interests you?
*
Which care plan interests you?
A
Essential Care — Daily personal care support
B
Companion Care — Companionship + light assistance
C
Complex Care — Advanced medical + dementia support
Type of care needed?
*
Type of care needed?
A
Personal Care
B
Dementia Care
C
Overnight Care
D
Companionship
Tell us about your situation
*
Request My Free Assessment