Get Started

Enroll a Patient

Starting care is simple. Fill out the form below and our care team will contact you within one business day to guide you through the next steps.

Enrollment Request Form

All fields marked * are required.

Patient Information

First Name *

Last Name *

Contact Information

Contact Name *

Relationship *

Phone Number *

Email Address

Care Details

Type of Care Needed *

City / Service Area *

Insurance / Coverage

Additional Notes

By submitting this form, you agree to receive text messages from Ability Home Health & Hospice at the phone number provided. Message frequency varies. Message and data rates may apply. Reply STOP to opt out at any time. Reply HELP for assistance. View our Privacy Policy and Terms of Service.

Prefer to Call?

Our care team is available Monday–Friday, 8 AM–5 PM. We're happy to walk you through the enrollment process.

(385) 287-1311

What to Expect

A care team member will contact you within one business day

We will help coordinate the physician referral process

An initial home assessment will be scheduled at your convenience