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Jan's experience

Serving Tucson Area

jantaplin@yahoo.com

520-415-6363

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Are you an A+ (ie. AWESOME) caregiver?

Are you

kind

considerate

honest

trustworthy

dependable

punctual

hard working

dedicated

and have a heart for helping others...

Amazing Caregivers, click here to apply

Follow Us

Contact Bob and Jan

Your First Name:

Your Phone number

First Name of person needing care

What tasks are becoming more difficult?

Getting Dressed

Walking Safely

Shopping/ Errands

Cooking

Cleaning House

Remembering to take Medication

Organizing my Paperwork

Driving Safely

Making the Bed

Getting in the Shower Safely

My kids think I need help, I think I am doing just fine.

Keeping track of doctor appointments

Remembering what the doctor(s) told me at the appointment(s)

The person needing assistance is

Me

My Mom

My Dad

My Grandfather

My Grandmother

My Aunt

My Uncle

My Neighbor

My Friend/ Acquaintance

Husband/ Wife/ Partner

Other

Your Email (if you have one)

Confirm that your phone and email are correct

Yes

Got it corrected!

How soon might you need care?

Gathering information at this time

In the next 24-48 hours

2-3 days from now

5-7 days from now

8-14 days from now

Next Month

Other important information about yourself and the assistance you are seeking.

Major cross streets or ZIP CODE

What are you most interested in/ or most need of? Check all that apply

Regular help in my home.

Someone to contact in Emergencies.

Someone to help manage and coordinate things.

This is all new to me, so I don't know what I need.

How did you hear about us?

Senior Fair

Read Article in Oro Valley Style Mag.

Google Search

Nextdoor

Pima Counsel on Aging Resource Guide

Heard Dr. Jan Speak at Senior Academy

Someone gave me your name/ card

We would like to thank the person who referred you...

IMPORTANT:

To protect your privacy, we ask only minimal questions on this form. We will ask more specific questions when we follow up via phone.

Also, if you do not hear back from us within 1 hour, please call 520-415-6363, as there could have been an issue with the message getting through. We don't want to miss an opportunity to provice excellent care to you or your loved one.

Thank you,

Bob and Jan

Do you agree to receive text messages from A Plus Elder Care Assistance sent from (520) 415-6363. Message frequency varies and may include information related to your inquiry, service updates and scheduling. Messages and data rates may apply. Reply STOP at any time to end or unsubscribe. For assistance, reply HELP or contact support at: (520) 415-6363.

Yes, I agree to receive text messages from A+ Elder Care Assistance sent from 520-415-6363

No, I don't want to receive text messages from A+ Elder Care Assistance.

Free Text

See our Privacy Policy for details on how we handle your information

Thank you for contacting us.

If you do not hear from us within 2-4 hours, PLEASE CALL 520-415-6363 in case there was a glitch in the system.

Thanks Much!

Jan and Bob

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Please call or text the office at 520-415-6363

Read the Privacy Policy Read the HIPAA Privacy Policy

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