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Comfort Keepers Claremont, CA

420 W Baseline Rd d
Claremont, California 91711
(909) 625-6151

Home Care Survey in Claremont, CA

Name: Comfort Keepers Home Care
Address: 420 W Baseline Rd d, Claremont, California, 91711
Telephone: (909) 625-6151

Finding the right care starts with understanding your needs. The Comfort Keepers home care survey in Claremont, CA, helps assess your unique situation, daily living needs, and personal preferences to determine the most appropriate level of in-home care. Complete the survey to take the first step toward personalized care and support that helps you or your loved one maintain comfort, independence, and quality of life.

Call us today at (909) 625-6151 to learn how Comfort Keepers can help your loved one live safely and comfortably at home.

About Your Loved One

Choose the following statements that apply to your loved one:

Does your loved one wear dirty clothing or the same outfit day after day?

Is it apparent your loved one is not showering or bathing?

Is your loved one losing weight?

Are there signs of confusion such as not knowing the date, where he/she is, or the season of the year?

Do the refrigerator or cupboards contain outdated food; or lack nutritious food?

Is the home cluttered or have mail, newspapers, bills accumulated?

Are you finding expired medications or medications that are not being taken?

ZIP Code where care is needed

About Yourself

Your first name

Your last name

Your email address

Your telephone number

Is this a cell phone number?

Anything else you would like to tell us?

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