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Help for family focus caregivers in nj

Does your parent

always take their

medications correctly

while you are away?

family focus caregivers

1-USS-4-GET-ME-NOT (1-877-443-8630)

Now, not only nj family focus caregivers can get help to keep aging parents alive and well, away from nursing homes and Hospitals.

The facts published in

The Washington Times,
August 6, 2003,

"Pharmaceutical noncompliance is a tremendous
problem in the United States
that drains an estimated
$100 billion from our national economy
every year,
and is blamed for the deaths
of over 125,000
Americans annually (342 people everyday).
Ten percent of all hospital admissions
are the result of pharmaceutical noncompliance,
and 23 percent of all nursing home admissions
are due to people's inability
to take their medications as prescribed."

To help you and

your parent maintain

independent living

We want to help nj family focused working caregivers with your mom, dad, or other loved one, to stay at home maintaining their independence.

Share a confidential copy of their schedule with us so we can assist you both with family focus caregivers nj and nationally.

While you are getting ready for work we can call for you and await their confirmation. Later, when you are working we can make calls for you to remind your loved one to take care of
living essentials, medications,
diet,
exercise,
chores,
entertainment
or personal events.
If they don't answer
we will contact EMS,
you or a neighbor,
as you desire.
We are family friendly.

PERHAPS A LIVE PHONE CALL
COMPLETED IN YOUR NAME AT THE RIGHT TIME
CAN HELP MAINTAIN THEIR
PRICELESS SELF-RELIANCE AND INDEPENDENCE AND
STOP
YOUR PARENT FROM
UNNECESSARY CONFINEMENT
THAT IS CAUSED BY NON-COMPLIANCE!

There are other services that
passively monitor
or use computers to make electronic signals
or await your parent or loved one to contact them,
(if possible).

AUDIO ANNOUNCEMENT
This picture will link to another site to help when you may not be able to speak or prefer another method for help-

We believe in the power of
a live human contact.
For quality assurance
all calls are scheduled to be recorded
and we have a backup system.
We can speak for you,
in your concern to check or chat,
for a few minutes during your workday.
We always reference
you in each call.
‘Nuclear families are swamped by everyday responsibilities.’
From personal experience with my own mother,
"I asked daily,
if she took her pills, she said 'took them."
When I got there,
(on the weekend) they were partly taken.
I could not call 3 times a day
and confirm her taking them at that time."
Personal Voice allows you time for yourself
with assurance of your loved one being called.
At the right time
and waiting until
they positively confirm.

TO HELP YOU AND YOUR PARENT
MAINTAIN INDEPENDENT LIVING

All nj family focus caregivers
standard service packages include fifteen calls;
will immediately prescribe to unanswered calls per your request,
a summary or digital copies of verbal confirmations by your loved one, and free birthday and anniversary reminders.
There are three weekly Standard Service levels-of care and concern:
Silver, Gold and Platinum,
for one, three and, fire minute call lengths.
Click on the navigation buttons for more info
or scroll down on the homepage
to see links at the bottom.
As a help to family focus, caregivers, nj.
Looking for more information.
as well as some alternative medicine

Those family focus caregivers seeking caregiver jobs can search for jobs & post Your Resume FREENow to attract top employers and employees!

YOUR CONTACT INFORMATION

Please note that all fields followed by an asterisk must be filled in.

First Name*
First Name*

Last Name

Home Phone

Business Phone

Street Address

City

State/Prov

Zip/Postal Code

Country

E-mail Address*
E-mail Address*

Fax

Cell Phone

Loved One's Name, First*
Loved One's Name, First*

Midlle Initial

Last Name

Home Phone*
Home Phone*

Cell Phone

Work Phone

Street address

City

State/Province

ZIP

Country

Your relationship
to loved one

(Include your name for loved one
If you believe it can be helpful- their name for you)

Service Details
Exactly what you want us to do
(Please detail and please give dates and time for all outside activities).
UNLESS OTHERWISE REQUESTED, ALL DAILY CALLS TO LOVED ONE’S HOME
ARE MORNING, NOON-TIME AND EVENING.

Wake up call (If so when)

Check up call

Medications

Check Blood Sugar

Check Blood Pressure

Diet

Meals on Wheels

Vitamins, Fiber, Herb Supplements

Exercise, Walk, Dance, Tai Chi, Yoga. Martial Arts

Salon/ Hair care

Doctor Appointments,
Prescription Refills

Schedule confirmation
Nurse
Homemaker

Elder Care
Transportation

CHORES

Entertainment
Activities

IF NOT IN EASTERN STANDARD TIME ZONE THEN PLEASE GIVE THEIR RELEVANT TIME ZONE*
IF NOT IN EASTERN STANDARD TIME ZONE THEN PLEASE GIVE THEIR RELEVANT TIME ZONE*

Health Status/Medical Condition, if yes please give details below*
Health Status/Medical Condition, if yes please give details below*

Allergies to Drugs?

Medic-Alert ID Card?

Advanced Medical Directive
or Living Will?

Primary Physician’s Name

Phone

Address

If there is no answer on the phone, what warrants a health crisis (Emergency) in your estimation?*
If there is no answer on the phone, what warrants a health crisis (Emergency) in your estimation?*

Do they go out often?

Is it okay for them to not take any of their medication?*
Is it okay for them to not take any of their medication?*

If needed what emergency contacts do you wish us to make?
Their Local Emergency Contacts
*For EMS ("911")-need the loved one’s local emergency service number.
Do any of below have key access?
*(911) often varies according to counties and municipalities. *
If needed what emergency contacts do you wish us to make?
Their Local Emergency Contacts
*For EMS ("911")-need the loved one’s local emergency service number.
Do any of below have key access?
*(911) often varies according to counties and municipalities. *

First Contact Name *
First Contact Name *

First Contact Phone Number(s)*
First Contact Phone Number(s)*

Key access?

	Yes
	No

Second Contact Name*
Second Contact Name*

Second Contact Phone Number(s)*
Second Contact Phone Number(s)*

Key access?

	Yes
	No

Third Contact Name

Third Contact Phone Number(s)

Key access?

	Yes
	No

Special Services

	A Assistance with writing or form completion, compiling information
	B Bill sorting coordination of bills to benefits
	C Consulting with Medical Staff on a limited basis
	D Medical Billing Problem Resolution
	E Negotiating with insurance companies for eligible benefits

Special Services:Please give additional information. Commonly a limited power of attorney for the specific circumstance is required.

Do you have any power of attorney?

Optional Services,
Presidential greetings arranged
Gift Suggestions,
Book and Film Finding (Purchasing at additional cost)
Special discussions of Old Time Radio, early Films, early Television

Birthday/Anniversary reminders

Signature
By submitting this application, I affirm that the facts set forth in it are true and complete.
I understand that if I am accepted as a client, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate cancellation.
This application will be considered part of the agreement, which client and loved one should sign.
There is no independent investigation; actions are entirely based on loved one’s verbal answers.
At this time only loved ones whose primary language is English can be accommodated
For protection and assurances all calls between client, loved one and third parties are to be recorded.

Client ‘s Name *
Client ‘s Name *

Typing name verifies signature*
Typing name verifies signature*

Date*
Date*

Love One’s Name *
Love One’s Name *

Signature

Date

You may find the following helpful -

Agreement by Personal Voice Inc. Your Forget-me-not Service in the Computer age

Please note that all fields followed by an asterisk must be filled in.

This is an Agreement made between PERSONAL VOICE, INC. a New Jersey corporation having an address at 4032 Route 516, Matawan, NJ 07747 (“PVI”) and (the “Client”)

First Name*
First Name*

Last Name*
Last Name*

Street Address*
Street Address*

City*
City*

State/Prov*
State/Prov*

Zip/Postal Code*
Zip/Postal Code*

Country*
Country*

Background:
A.
Attached hereto is a copy of an Application filled out by the Client with respect to PVI Services desired by Client to be rendered to the Client’s “Loved One”.
B.
The information, terms and conditions of the Application are hereby made part of this Agreement; and terms in quotation marks in this Agreement but not defined herein but rather are defined in the Application
C.
PVI hereby accepts the Application, based upon the truthfulness and completeness of the information supplied in the Application.
NOW, THEREFORE, it is agreed as follows:

1.
Term of this Agreement

1.1
The “Term’ of this Agreement

shall commence on **
shall commence on **

and shall continue for**
and shall continue for**

days, after which either party, without cause, may terminate this Agreement on three (3) days’ written notice.
1.3
This Agreement may be terminated by PVI at any time for “Good Cause”, which shall include (a) material misrepresentations or omissions in the Application; (b) lack of cooperation (voluntarily or involuntarily) of the Loved One or of the Client and (c) failure to pay PVI for its services within three (3) business days after the due date of the payment.
1.4
In case of termination by Client for Good Cause, the Client shall be entitled to a pro-rata refund of any prepayment on a per diem basis. In case of termination by PVI for Good Cause, Client shall not be entitled to any refund

2
Obligations of Client to Update Information in the Application
Client agrees immediately to advise PVI of any material change of the information concerning the Loved One contained in the Application and of any change in the contact information for Client.
3
PVI SERVICES
3.1
The weekly services to be provided by PVI during the Term are as follows [check one]

	Silver Package Fifteen(15) one-minute calls/week $22.00 per week plus $1.00 per excess minutes
	Gold Package Fifteen(15) three minute calls/week $50.00 per week plus $1.00 per excess minutes
	Platinum Package Fifteen (15) five minute calls/week chatting or waiting up to five minutes for confirmation $85.00 per week plus $1.00 per excess minutes

Customized calls

There also are Special Services at an additional rate Billed in Fifteen Minutes Increments of $60/hr discounted to $40/hr only with gold and platinum packages.(check desired and send or paste specific information)

	A Medical Billing Problem Resolution
	B Bill sorting coordination of bills to benefits
	C Negotiating with insurance companies for eligible benefits
	D Consulting with Medical Staff on a limited basis
	E Assistance with writing or form completion, compiling information

Special Services Specifics

optional fun services$60/hr flat rate also billed in fifteen minute blocks.

	1-Presidential greetings arranged
	2-Gift Suggestions, Book and Film Finding (Purchasing at additional cost)
	3-Special chats of Old Time Radio, early Films, early Television

Specify Fun Services

3.2
The specific reminders or other communications to be made with the Loved One are set forth in the Application
4
Payment to PVI
4.1
Contemporaneously with the execution of this Agreement by PVI and the Client, the Client agrees to pay and is paying to PVI the “Set-up Fee”.Set-up Fee waived when submitted via this page.
4.2
While PVI’s Services will be performed on a weekly basis, the ”Service Fee” must be paid one month in advance, on the* *

3.2
The specific reminders or other communications to be made with the Loved One are set forth in the Application
4
Payment to PVI
4.1
Contemporaneously with the execution of this Agreement by PVI and the Client, the Client agrees to pay and is paying to PVI the “Set-up Fee”.Set-up Fee waived when submitted via this page.
4.2
While PVI’s Services will be performed on a weekly basis, the ”Service Fee” must be paid one month in advance, on the* *

day of each month, commencing on**
day of each month, commencing on**

5
Limitations of Liability
CLIENT HEREBY AGREES THAT PVI, ITS DIRECTORS, OFFICERS, EMPLOYEES AND INDEPENDENT CONTRACTORS HIRED BY PVI TO PERFORM PVI SERVICES SHALL NOT BE LIABLE FOR FAILURE PROPERLY TO PERFORM PVI SERVICES, EXCEPT FOR GROSS NEGLIGENCE OR WILLFUL MISCONDUCT.

6
Non-binding Mediation before Litigation
6.1
Agreement to Mediate
a
All claims or disputes arising out of or in any way relating to this Agreement or any of the parties' respective rights and obligations arising out of this Agreement, the parties agree that before proceeding to litigation they will first submit the claim or dispute to non-binding mediation by a single mediator in Monmouth County, New Jersey, under the auspices of (1) the American Arbitration Association (the "AAA"), in accordance with the AAA's "Commercial Mediation Rules" then in effect, or (2) under the auspices of JAMS or any other mediation service agreed upon by the parties

b
A party to this Agreement having a claim or dispute subject to paragraph 6.1 may not institute any legal action against any other party to this Agreement unless the mediation proceedings have been terminated as a result of a written declaration of the mediator that further mediation efforts are not worthwhile
6.2
Expenses of Mediation
The fees of the AAA or other mediation service and the mediator shall be borne one-half by the Company and one-half by Client.

6.3
Enforceability
A party's right to mediation may be specifically enforced by said party.
6.4
Certain Limitations
All statements, promises, offers, views and opinions made or communicated by any party in the mediation proceeding will be secret and confidential in all respects, and will not be discoverable or admissible for any purposes, including impeachment, in any litigation or other proceeding between the parties. However, evidence otherwise discoverable or admissible will not be excluded from discovery or admission as a result of its use in the mediation proceeding.

7
Entire Agreement; Modification
7.1
This Agreement, together with the Application, constitutes the entire and only agreement between the parties and supersedes any and all prior or contemporaneous agreements, representations, and understandings with respect to PVI ServicesThis Agreement may be modified only by a writing signed by PVI and Client.

PERSONAL VOICE, INC. by Joseph or Victoria Quinn

Client by typing name verifies signature**
Client by typing name verifies signature**

Over 18 years of age*
Over 18 years of age*

	Yes
	No

Fast Feedback To Us
or Call 1-877-443-8636-1-USS-4-GET-ME-NOT

Please note that all fields followed by an asterisk must be filled in.

Only Form Out If you want us to reply. Thanks

First Name*
First Name*

Last Name

E-mail Address*
E-mail Address*

City

State/Prov

Zip/Postal Code

Country

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What are you looking for

Are you a caregiver

	Working with a senior
	Seeking employment as a caregiver
	Working as a paid caregiver
	Needing additional income at home
	See our free webpage offer
	See our caregiver job description

Websites for general information on caregiving

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Our best choices for websites on caregiving

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Legal issues about caregiving

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Spiritual concerns in caregiving

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Chat boards for caregivers

	yes
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Disclaimer
With the above adjacent services

Personal Voice Inc. can not and will not be held responsible for any failure on their part to achieve required results for any reason on behalf of client

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