Senior Services - About Senior Solutions

Last Name:
First Name:
Relationship to Senior:
Email:
Phone:
Address:
City:
State:
Zip:
SeniorName:
Age:
Biggest Concern:
Does Your Loved One Need:
DressingAssistance:	Yes No
MedicationManagement:	Yes No
SpecialDementia:	Yes No
WalkingAssistance:	Yes No
Monthly Budget:
Are you Looking for:
Home Care Options:
Health Care Options:
Would you like information on:
Independent Living:	Yes No
Assisted Living:	Yes No
Dementia/Alzheimers Care:	Yes No
Board and Care:	Yes No
What Cities are you interested in?:
Have you already Contacted Facilities?:
Which Facilities:
Would you like information on:
Geriatric Evaluation:	Yes No
Care Management:	Yes No
Financial Planning:	Yes No
Elder Law Attorney:	Yes No
Life / LongTermCare Insurance:	Yes No
Reverse Mortgage:	Yes No
Real Estate Services:	Yes No

ABOUT SENIOR SOLUTIONS
525 South Myrtle Ave
Suite 208
Monrovia, CA 91016
626-359-0108
909-624-3223
888-736-5864
Fax: 626-359-0111
aboutseniorsolutions@gmail.com

WHAT OUR CLIENTS ARE SAYING

"After my mother's death, my father was all alone and getting more and more depressed. Thank you so much for finding a great place for him to go. He is now enjoying his time with friends and neighbors."

-- SP, Covina, Ca

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GERIATRIC EVALUATION

a personalized plan to enhance a senior's quality of life
performed by an experienced professional in the home setting of the senior
receive a written report to present to physicians and other health care providers
organizes pertinent health care information
provides referrals for care
empowers Seniors and Caregivers
Provides solutions and peace of mind