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| Project Name: Senior Companion Care - With Transportation |
| Project Location: Prescott Valley, AZ |
| Date: 05/27/2012 |
| Age:: Age: |
| First Name:: First Name: |
| Care recipient: Mother |
| Living situation:: Home (lives with spouse) |
| Companion services:: Errands/Shopping |
| Transportation needed: Yes |
| Care type:: Visiting care |
| Personal services: None |
| Ambulation:: Independent |
| Estimated timing: Immediately - within 1 week |
| Expected funding: Private |
| Receptiveness:: Very receptive |
| Gender:: Female |
| Comment: Needs help with driving to places |
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| Project Name: Senior Companion Care |
| Project Location: Prescott Valley, AZ |
| Date: 05/09/2012 |
| Care recipient: Other Relative |
| Living situation:: Home (lives alone) |
| Companion services:: Errands/Shopping |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: None |
| Estimated need:: 21 to 40 hours/week |
| Estimated timing: Immediately - within 1 week |
| Expected funding: Private |
| Estimated budget:: $251 to $500/week |
| Gender:: Female |
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| Project Name: Senior Companion Care - With Transportation |
| Project Location: Prescott Valley, AZ |
| Date: 01/26/2012 |
| Age:: Age: |
| First Name:: First Name: |
| Care recipient: Myself |
| Living situation:: Home (lives with partner) |
| Companion services:: Social activities |
| Companion services:: Exercise/Physical activities |
| Companion services:: Other activities |
| Transportation needed: Yes |
| Care type:: Visiting care |
| Personal services: None |
| Ambulation:: Independent |
| Estimated timing: Immediately - within 1 week |
| Expected funding: Private |
| Receptiveness:: Very receptive |
| Gender:: Female |
| Comment: lost my vehicle |
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| Project Name: Senior Companion Care |
| Project Location: Prescott Valley, AZ |
| Date: 01/24/2012 |
| Care recipient: Other Relative |
| Living situation:: Home (lives alone) |
| Companion services:: Errands/Shopping |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: None |
| Estimated need:: 21 to 40 hours/week |
| Estimated timing: Immediately - within 1 week |
| Expected funding: Private |
| Estimated budget:: $251 to $500/week |
| Gender:: Female |
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| Project Name: Senior Personal Care - With Transportation |
| Project Location: Prescott Valley, AZ |
| Date: 01/14/2012 |
| Age:: Age: |
| Care recipient: Other Relative |
| Living situation:: Assisted Living |
| Companion services:: Meal prep |
| Companion services:: Light housekeeping |
| Companion services:: Medication reminders |
| Transportation needed: Yes |
| Care type:: Visiting care |
| Personal services: Eating/feeding |
| Personal services: Yes |
| Estimated need:: Up to 10 hours/week |
| Expected funding: Both private & other |
| Gender:: Male |
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| Project Name: Senior Companion Care |
| Project Location: Prescott Valley, AZ |
| Date: 01/11/2012 |
| Age:: Age: |
| First Name:: First Name: |
| Care recipient: Mother |
| Living situation:: Lives with family |
| Companion services:: Meal prep |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: None |
| Ambulation:: Walker |
| Estimated timing: Within 3 to 4 weeks |
| Expected funding: Private |
| Receptiveness:: Somewhat receptive |
| Gender:: Female |
| Comment: In new area. Husband out of town. Cannot leave Mom alone for 13 hrs when I work, 3 days a week. |
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| Project Name: Senior Personal Care |
| Project Location: Prescott Valley, AZ |
| Date: 01/05/2012 |
| Age:: Age: |
| Care recipient: Spouse |
| Living situation:: Home (lives with spouse) |
| Companion services:: Other activities |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: Toileting |
| Personal services: Yes |
| Estimated need:: 21 to 40 hours/week |
| Expected funding: Private |
| Gender:: Female |
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| Project Name: Senior Companion Care - With Transportation |
| Project Location: Prescott Valley, AZ |
| Date: 12/13/2011 |
| Care recipient: Spouse |
| Living situation:: Home (lives with spouse) |
| Companion services:: Light housekeeping |
| Companion services:: Exercise/Physical activities |
| Companion services:: Errands/Shopping |
| Transportation needed: Yes |
| Care type:: Visiting care |
| Personal services: None |
| Comment: Live in own home/assistance with stand by bathing/ excersise/mobility / home care/light house work / transportation assistance for shopping appointments memory assiat |
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| Project Name: Senior Companion Care |
| Project Location: Prescott Valley, AZ |
| Date: 11/29/2011 |
| Care recipient: Other Relative |
| Living situation:: Home (lives alone) |
| Companion services:: Errands/Shopping |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: None |
| Estimated need:: 21 to 40 hours/week |
| Estimated timing: Immediately - within 1 week |
| Expected funding: Private |
| Estimated budget:: $251 to $500/week |
| Gender:: Female |
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| Project Name: Senior Companion Care |
| Project Location: Prescott Valley, AZ |
| Date: 11/22/2011 |
| Care recipient: Other Relative |
| Living situation:: Home (lives alone) |
| Companion services:: Errands/Shopping |
| Transportation needed: No |
| Care type:: Visiting care |
| Personal services: None |
| Estimated need:: 21 to 40 hours/week |
| Estimated timing: Immediately - within 1 week |
| Expected funding: Private |
| Estimated budget:: $251 to $500/week |
| Gender:: Female |
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