Simplify Your Life & Call  (520) 433-4964

Patient Forms & Eligibility

Prior to your initial appointment we will need to you to fill out our New Patient Registration Packet. This packet includes our Privacy and Financial Policies, Authorization for Release of Medical Records, and Registration Form. If you would like us to provide medical information or speak to family members on your behalf, please complete a medical Power of Attorney form (not included in this packet) and fax or email it to our office.

Download our home health care printable brochure


Insurance eligibility verification done prior to enrollment

Other eligibility criteria include:

  • Inadequate access to transporation
  • Mobility complications and risk of falls
  • Difficulty understanding physician instructions
  • Frequent visits to hospitals, emergency departments and nursing facilities
  • Significant need for coordinated care
  • Complex, chronic disease
  • Difficulty remembering or keeping appointments at multiple medical offices and labs