A clear first step

Tell us what kind of help you are considering.

Share only the basics. No phone call is required to begin, and we will contact you before any information is sent to a separate care provider.

Start the short form

Private by design No medical records or diagnosis detailsNo charge Families do not pay to submit a requestYour choice You decide whether to speak with a provider

Which path are you considering?

Help at homeCare in the person’s current homeFind a communityIndependent, assisted or memory careNot sureTalk through the next practical step

Tell us the basics

Type of helpWhen are you considering care?TownZIP codeWho is this request for?

How should we contact you?

First nameLast namePhone (optional)Email (optional)Preferred contact

Please keep sensitive details out of this form.

Do not submit diagnoses, medical records, medication lists, Social Security numbers, bank details or insurance documents.

There is no charge to submit this request. Availability, suitability, eligibility, timing and price are not guaranteed.

Before you send

A limited request with clear boundaries.

What happens after I submit?

We review the basic routing information and contact you by your chosen method. Before information is sent to a separate care provider, you are told who may receive it and asked for appropriate permission.

Is a provider guaranteed to be available?

No. Territory, schedule, availability, eligibility, price and fit must be confirmed directly. A request is a starting point, not a reservation or care agreement.

What should I leave out?

Do not submit diagnoses, medical records, medication lists, Social Security numbers, bank details or insurance documents. A provider can explain any secure intake process later.

Does submitting cost anything?

There is no charge to submit a request. Participating providers may compensate Vermont Senior Care for marketing or introductions; that does not make a provider clinically recommended or best for everyone.