The Proud Life Home Care Client Intake Form

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The Proud Life Home Care Intake Form makes it easy for our clients to get the professional care they require. We can gather information from our intake form to set up a face-to-face homecare consultation. The in-home consultations offered by Proud Life are all completely free. We are aware that receiving the assistance you require can be expensive—not with us. Our goal is to help you save time and money. With homecare, you can now take care of your health needs without having to visit the hospital and pay hundreds of dollars for a single day of care. Our client's personal information on the intake forms is private and protected. No personal information is sold or provided to any 3rd-party customers or companies. Please read the privacy policy for more details on how Proud Life Homecare protects your information.