Contact us Speak to a Care Advisor "*" indicates required fields Δ Step 1 of 4 25% Client Information:Full Name*Phone Number*Email Address Preferred Contact Method*Preferred Contact MethodEmailPhoneTextBest Time to Reach You*Best Time to Reach YouMorningAfternoonEvening Care Services Needed:What type of care are you interested in?* Personal Care (help with bathing, dressing, grooming, etc.) Companion Care (companionship, social activities, conversation) Homemaking (light housekeeping, meal prep, running errands, etc.) Respite Care (temporary relief for family caregivers) Other (Feel free to check all that apply. I’m here to help you find exactly what you need!)Please describe your case*Are there any special care needs or concerns you’d like us to know about? Payment and Insurance Information:How would you like to pay for home care services? Private Pay (out-of-pocket) Long-Term Care Insurance (if you have coverage) Medicaid (for eligible services) Other Please add payment method*Do you want assistance with Medicaid eligibility/enrollment: Yes No Medicaid ID Number Care Schedule:When do you need home care services to start?* Immediately Within the next 1-2 weeks In a month or more Is this a time-sensitive situation?* Yes No If yes, please tell me more so we can help prioritize your needs:* Phone:212-202-0920Fax: 718-646-3444Email: Intake@incarehhc.com Office Address: 1820 Gravesend Neck RoadBrooklyn, NY 11229
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