Personal Care Management Services : What We Do 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Referral Date and TEMPUS Assigned Consumer # at the top of the form. This information is crucial for tracking your referral.
3. Fill in the Consumer's personal details, including Name, Email, Phone, Cell, Home Address, Mailing Address, SS#, DOB, and Gender. Ensure accuracy as this data is essential for service provision.
4. Indicate if the Consumer is a minor by selecting 'Yes' or 'No'. If applicable, provide Parent(s) names and their relationship to the minor.
5. Complete the section regarding previous PCA services or consumer-owned business by answering 'Yes' or 'No', and if 'Yes', include the EIN.
6. Select the Care Program and fill in any relevant agency details. This helps in determining eligibility for various programs.
7. Provide information about the Surrogate/AP including Name, Email, Phone, Address, and their relationship to the Consumer.
8. Finally, choose where to send the Welcome Package by selecting either Agency or Consumer. Confirm that all fields are filled out correctly before submission.

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