Call: 334-607-7622

Call: 334-607-7622

HOME MODIFICATION FORMS

Please fill out the form below. When you have completed the form, you can return to this page and upload it to the step 2 form. 

1

Step 1: Upload Our Consent Form By Clicking The Button Below

Your information will be secure and used only to help with patient/client onboarding.

2

Step 2: Return Here To Upload Your Form

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FAQ

  • What happens during the home modification visits

    We make go over everything that you cannot or are having trouble doing in your home and how to change this so that you can move safely in your home. We may go over equipment, education, and any other recommendations made to home/apartment.
  • Will this really help me?

    We have helped many people life happily in their home again. We are confident we will be able to help you move better and safer in your home. Feel free to give us a free call to see how we can help you.
  • How much does this cost?

    The costs are XXXXXXXX.
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