multi step form

Let's see where you're located.

clint? - Customer Success Representative

What is your zip code?

Let's see how we can help.

clint? - Customer Success Representative

What best describes your situation?

Personal care (bathing, dressing, daily activities)

Companion care

Not sure — need guidance

Let’s see your relation to them.

clint? - Customer Success Representative

Let’s see who will receive care.

clint? - Customer Success Representative

️ Who are you looking to receive home care services for?

For myself

For a family member / patient I help care for

Let’s see the patient’s age.

clint? - Customer Success Representative

Let’s see who can care for you.

clint? - Customer Success Representative

️Do you have a family member or loved one who couldhelp care for you if they were eligible to be paid?

Yes

No

Not sure

Let’s see how old you are.

clint? - Customer Success Representative

️What is your age range?

Under 65

65 or older

Let’s see the patient’s age.

clint? - Customer Success Representative

️What is the patient’s age range?

Under 65

65 or older

Let’s see their Medicaid status.

clint? - Customer Success Representative

️Does the patient currently have ACTIVE Medicaidcoverage?

Yes — Active Medicaid

No

Not sure

Let’s see the approved care hours.

clint? - Customer Success Representative

️Has Medicaid already approved home care servicehours for the patient?

Yes — Hours already approved

No — Not approved yet

Not sure

Let’s see your start date.

clint? - Customer Success Representative

️When are you looking to start home care services?

As soon as possible

Within 30 days

Just researching options

Let’s see how to reach you.

clint? - Customer Success Representative

Let's see where you're located.

What is your zip code?

Let's see how we can help.

What best describes your situation?

Let’s see your relation to them.

️What is your relationship to the patient?

Let’s see who will receive care.

️ Who are you looking to receive home care services for?

Let’s see the patient’s age.

️What is the patient’s age range?

Let’s see who can care for you.

️Do you have a family member or loved one who couldhelp care for you if they were eligible to be paid?

Let’s see how old you are.

️What is your age range?

Let’s see the patient’s age.

️What is the patient’s age range?

Let’s see their Medicaid status.

️Does the patient currently have ACTIVE Medicaidcoverage?

Let’s see the approved care hours.

️Has Medicaid already approved home care servicehours for the patient?

Let’s see your start date.

️When are you looking to start home care services?

Let’s see how to reach you.

Contact Info

Hi, I'm clinte?, I'm your dedicated contact at Sara Care.

Which state do you live in?