Form Downloads / Fees / Services

Download PDF Forms

Please click links below to download and print:

• Fees and Services
• Authorization to Release Information
• Release of Liability – Client Transportation
• Determining the Need for Help – Booklet

Fees and Services

Preliminary Information Regarding Geriatric Care Management & Professional Fiduciary Services:

Complimentary for 30-minute phone or in-office session.

Psychosocial Assessment:

Formal written report of client’s functioning, recommendations for services, change in level of care regarding current living situation, interventions and plan of care to be established. — $120/hour

Care Management (Aging Life Care Specialist) & Professional Fiduciary Services:

Coordination of services, transport to medical appointments, ongoing advocacy and evaluation of clients to make certain daily needs are met, education for families in negotiating social service and health system, acting as liaison for families and/or caregivers out-of-area, assist in relocation to alternative living situation. A minimum 1 hour visit each month is required. — $120/hour. Principal Fiduciary/Fiduciary Services rate — $145/hour.
A refundable $500.00 retainer is required and must be provided upon engagement of services, prior to any services being scheduled or performed.

Aging Life Care Assistant (Para-Professional):

Coordination of services, transport to medical appointments, ongoing advocacy and evaluation of clients to make certain daily needs are met under the supervision of an Aging Life Care Specialist. Lab appointments, podiatry, dental, etc. at the discretion of the Aging Life Care Specialist assigned. — $80/hour.

Mediset Visits:

Includes a visit by a licensed nurse to set up medications bi-monthly or monthly in a mediset, maintain a medication list, take vitals. — $120/visit

Support Services:

Faxes, emails, phone calls, mailings, shopping, deliveries, etc. by office staff. — $50/hour

Health Care Power of Attorney / Mental Health Power of Attorney Appointments:

One time, nonrefundable, fee. Includes consultation, account set up, and on-call status in case of emergency. — $450 Individual / $600 Couple

Mobile Notary Services:

Notary rates starting at $45.00 per transaction – start date to be determined.

Payments:

Payments are due in our office 15 days from the date on the invoice. We accept payment by credit card or debit card which includes a 3.5% convenience fee. A 10% late payment charge will be applied if payment is not received within 15 days of the date on the invoice.

• Per hour services are pro-rated at 6-minute intervals (.10).
• We do not charge mileage, client set up fees for care management, or administrative fees; however, travel time is billed in addition to amount of time incurred for the above services.
• No additional charges for evening/weekend emergency calls – normal rates apply. We encourage routine matters and non-emergency calls be directed to our office during regular business hours,
  Monday – Friday 8 AM – 5 PM.

Effective 9.1.24