REFERRAL

Candidates for our services include individuals of any age who:

  • Have persistant functional deficits and require ongoing assistance with day-to-day tasks and personal care.
  • Have a chronic illness that impacts their ability to care for themselves.
  • Are at risk for physical, psychological or functional decline.
  • Reside in an assisted-living or long-term care facility and would do well with the extra attention provided by a one-on-one companion.

To make a referral, please have your doctor fill out this form and fax it to (718)424-4970. You can also call us at (718)215-5320, or e-mail us at info@atyoursidehc.com.