Caring Hands Gentle Hearts

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Client Intake

A gentle first step toward care.

Share a little about your loved one and the kind of support that would help. Everything stays private and is used only to prepare your consultation.

Client Information

Client's full name*

Age (optional)

Home address*

Primary Contact

Your full name*

Relationship to client

Phone number*

Email address*

Care Needs

Preferred start date

Schedule preference

Services of interest

Personal Care AssistanceMobility & TransfersCompanionshipMeal PreparationLight HousekeepingMedication RemindersRespite for Family

Health conditions or mobility considerations

Anything else you'd like us to know

Your information is kept confidential and used only to prepare for your consultation. We follow HIPAA privacy standards.

Compassionate, dependable, mobile non-medical home care — staffed with trained CNAs — proudly serving families across Harford and Baltimore Counties, Maryland.

We are committed to protecting your privacy. All personal and health information is handled in accordance with HIPAA confidentiality standards.

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Care Area & Hours

Harford & Baltimore Counties, MD
Mon–Fri: 8:00 AM – 5:00 PM EST
Saturday: 9:00 AM – 1:00 PM EST
Sunday: On-call only

© 2026 Caring Hands Gentle Hearts. All rights reserved.

Compassionate Care. Heartfelt Homes.