Request care management

A few questions about the situation, then how to reach you. Stacie reviews each request personally and follows up to discuss scope and capacity.

The situation

Who needs coordination?

Which description fits best?

Where does that person live?

Care management is hands-on and local, so this decides fit.

Where are they right now?

How soon is coordination needed?

What would you want covered?

Choose everything that applies. Scope is agreed in writing before any engagement begins.

Hospital or rehab advocacy and discharge planningAppointments and coordination between providersMedication and daily-routine oversightBenefits and paperwork organizationScheduled updates back to the familyHousehold and day-to-day arrangementsNot sure yet

What is happening right now?

A few sentences is plenty. Do not include diagnoses, records, account numbers, or policy numbers.

Where to reach you

Name

Phone

Preferred contact method

Best time to reach you (optional)

I understand care management is a private-pay service, billed for Stacie's time, and is not covered by Medicare or health insurance.

I agree that Ruskin Senior Services may contact me about this service request. I have read the privacy notice.