Client Application

You’re decided! You’d like GYC Senior Care to handle the care of your loved one. Beautiful choice! We appreciate and value your trust and are looking forward to extending our family treatment to your loved one.

Now, here’s what you need to do in order to sign up:

  1. Please download the forms at the bottom of this page,
  2. Fill them out on your computer,
  3. And send them back through this client application form.

We’ll be happy to get back to you in a timely manner.
The signatures on the forms are not mandatory and can be done when meeting our Specialist.

Contact Info

Client Forms

Client Service Agreement

  • Authorization and agreement for home services.

Client Service Plan

  • List of services.

ACH Authorization Form

  • Authorization form for ACH payment.

Scope of Home Care Services

  • Detailed breakdown of the scope of GYC’s home care services.

Ready To Greatly Improve Your Quality of Life?

Contact Us