Care Assessment
Telephone Inquiry Form
The first conversation: who is calling, what is going on, and how we can help.
About 6 minFamilies & care team
Forms & Documents
Everything you need,
in one secure place.
Complete your Golden Grace paperwork online in a few guided steps, or download a printable copy to fill in at home.
Private & secure
Submissions go directly to our care team only.
Save time
Guided steps with progress saved as you go.
Prefer paper?
Download any form and complete it by hand.
Care Assessment
Client In-Home Assessment & Care Plan
A complete picture of health, daily routines, home safety and care goals to build a personal care plan.
About 25 minClients, families & care team
Client Onboarding
Client Identification Form
Essential identification, responsible party and emergency contact information for new clients.
About 5 minNew clients & responsible parties
Client Onboarding
Informed Consent Agreement for Home Care Services
Consent for non-medical home care services, supervision, risk, cancellation and termination terms.
About 10 minClients, parents or POA
Client Onboarding
Client Rights & Responsibilities
Your rights as a Golden Grace client, your responsibilities, and how to raise concerns.
About 4 minAll clients
Client Onboarding
HIPAA Privacy Acknowledgment Form
Confirms you received our Notice of Privacy Practices and understand your privacy rights.
About 3 minAll clients
Client Onboarding
Client Choice & Transfer Statement
Confirms you chose Golden Grace freely, and records details if you are transferring from another agency.
About 4 minNew and transferring clients
Client Onboarding
Authorization & Release to Drive Vehicle
Authorizes caregivers to transport the client in a named vehicle, with insurance and release details.
About 5 minClients & vehicle owners
Billing & Agreements
Private Pay Client Agreement
Rates, deposit, financial responsibility and placement terms for private pay services.
About 10 minClients & financially responsible persons
Billing & Agreements
Credit Card Authorization Form
Authorizes charges for deposit and/or services under the Private Pay Agreement.
About 3 minCardholders
Billing & Agreements
Authorization for Direct Payment via ACH
Authorizes electronic debits for the deposit and bi-weekly invoices.
About 4 minClients & responsible parties
Caregiver
Background Check Authorization Form
Authorizes a background check and investigative consumer report for employment purposes.
About 5 minCaregiver applicants
Client Guides
Service Levels & Pricing Guide
Four levels of care, what each includes, and estimated hourly rates.
About 2 minFamilies planning care
Client Guides
New Client Welcome Packet
Our mission, office hours, billing, feedback, privacy, infection control and emergency preparedness.
About 12 minNew clients & families