Do you or an elderly loved one or family member need help navigating the health care system? If yes, please continue answering the questions below. Do you lay awake at night worrying whether medications have been forgotten?(Required) Yes No Do you have questions about any medical care being received?(Required) Yes No Does anyone forget instructions given at medical appointments?(Required) Yes No Are you concerned that those instructions are being followed accurately?(Required) Yes No Do you live far away from family that are vulnerable and are unsure if they are receiving quality medical care?(Required) Yes No If anyone needs to be hospitalized or have a medical emergency, is someone available to be at their bedside to make sure appropriate care and follow up arrangements are being made?(Required) Yes No Do you need someone to coordinate medical care between different doctors?(Required) Yes No Are you worried that insurance is billing appropriately with no errors?(Required) Yes No Do you feel a health and wellness evaluation would be beneficial for helping maintain independence?(Required) Yes No Name(Required) First Last Email(Required) Phone(Required)
