Service Needs Checklist

If you or someone you know is being physically or emotionally abused, neglected, or financially exploited, DO NOT fill out this checklist – instead, please call the PCA Helpline immediately: 215-765-9040 or toll-free (from outside Philadelphia) 888-482-9060, 24 hours a day, seven days a week.

The information you provide is strictly confidential and will not be shared with anyone without your express permission. This checklist is designed to help you determine what kinds of services are available to help you, or the person you are caring for, to achieve optimum levels of independence.

As you complete the checklist, you will receive information about services available from PCA and others. When you are finished, you may choose to have the information emailed to you.

Milestones eNews

For seniors and those who care for them

PCA News Bulletin

For professionals in the field of aging