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Refer Someone Today

We appreciate your confidence in A-Mission of Home Health Care, Inc. to provide you with personal and professional care. If you or someone you know needs medical help in the home and you would like to know if you qualify for these benefits, please complete the form below. When finished, click the "Send" button. All information is sent via a secure server to insure privacy.


Your Information
Please provide your contact information below. Then tell us as much as you can about the patient's home care needs so we may best respond to your inquiry:

Patient Information
Has this patient previously received home care services?
Screening - Does Client:
Use Telephone?
Get out of bed unassisted?
Walk unassisted?
Operate a motor vehicle?
Shop for essentials?
Handle money/pay bills?
Prepare Meals?
Eat Unassisted?
Do routine housework?
Do laundry?
Dress and undress self?
Shower/Bathe/Groom self?
Get to toilet in time?
See physician frequently?
Follow medical directions?
Have prescribed medications?
Have diabetes?
Receive home health?
Have a physician?
Have physician-ordered therapies?
Have adequate informal support?
Seem confused?
Have ability to share in cost of care?

Submit Information



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3455 Highland Road, Suite 200
Dallas, TX 75228
Phone: 214-327-9656
Fax: 214-327-9888
Email: info@amissionofhhc.com

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A-Mission of Home Health Care in Dallas, Texas provides services including skilled nursing care, home health aides, and rehabilitative services. Our goal is to provide comfort and security to the elderly and handicapped in familiar surroundings. Contact us for all your Home Health Care needs in Dallas, TX.

  
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