Client Forms Library
Client Forms Library
All BridgeCare client forms are available to fill out online. After submitting, you can print a completed copy for your records. No downloads required.
How it works:
- Click Open Form on any form below.
- Fill out the form completely online.
- Click Submit — your form is sent securely to our team.
- After submitting, use your browser's Print function ( Ctrl+P / Cmd+P) to save a copy for your records.
All Client Forms
Client Intake Form
New client registration — personal info, physician, insurance, and service request.
Client Assessment Form
Mobility, bathing, dressing, meal prep, medication, safety, and fall risk assessment.
Service Request Form
Request home care services, schedule, and describe your care needs.
Transportation Request Form
Schedule non-emergency medical transportation and wheelchair rides.
HIPAA Authorization Form
Authorize BridgeCare to share your health information with designated individuals.
Consent to Services
Authorize BridgeCare to provide home care and/or transportation services.
Emergency Contact Form
Provide emergency contacts and medical information for your care file.
Complaint / Grievance Form
Submit a formal complaint or grievance regarding BridgeCare services.
Client Referral Form
Refer a client to BridgeCare home care or transportation services.
Client Rights & Responsibilities
Review and acknowledge your rights and responsibilities as a BridgeCare client.
Release of Information
Authorize BridgeCare to release your health information to a designated person.
Care Plan Review
Review and update your current care plan, goals, and caregiver instructions.
Document Upload
Securely upload insurance cards, physician orders, identification, and other documents.
Need Help With a Form?
Call us and our intake coordinators will walk you through any form over the phone.