Online Pre-Assessment

Complete the questionnaire below to begin thinking about the level of care you may need. Even if you do not know exactly what you need, please remember, Ella Home Care works with you one-on-one to develop a plan just for you.

I need care for:*
We need help because he/she is:*
Please Define Other
When will you need the help:
- In the morning
- Afternoon/ Evening
- Overnight
- 24/7
- Don’t know
How often will you need the help:
- 1-2 days per week
- 3-5 days per week
- 5 days per week
- 7 days per week
- Don’t know
Home Care Professionals will need to assist with: (check all that apply)
- Getting up in the morning
- Walking
- Bathing
- Incontinence
- Dressing
- Errands and/or Transportation
- Housekeeping
- Companionship
- Meal preparation
- Feeding
- Toileting
- Medication Reminders
- Getting ready for bed
- Help with pet
I would like Ella Home Care to contact me:
Name*
First Last
Phone*
Email
Name
This field is for validation purposes and should be left unchanged.

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Our Promise To You

All calls answered by a live person
Engaged & well trained home care professionals
24/7 access to your loved one’s care plan through our online portal
We will listen more than we talk
We will work one-on-one to develop your care plan

Download Our Brochure

Contact Us

Ella Home Care
Address:
839 Market Street
Lemoyne, PA 17043

Phone: (717) 963-7280
Fax: (717) 695-2892

Email: info@ellahc.com

I would like Ella Home Care to contact me:

Our Promise To You

Download Our Brochure

Contact Us