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Client's Date of Birth
Has the client ever received home health care service in the past?
Client lives in a
House/ApartmentAssisted/Supportive LivingSenior HousingGroup HomeRented RoomNone of the Above
Is the client able to drive a car safely on a regular basis?
Does the client use any type of assistive device e.g. cane, walker, wheelchair?
Is the client willing to receive home health services?
415 Columbia Road,Dorchester MA 02125