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Last
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(Required)
Brooklyn
Bronx
Manhattan
Queens
Staten Island
Rockland
Suffolk County
Nassau County
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(Required)
A licensed Home Health Aide (HHA)
A licensed Personal Care Aid (PCA)
Looking for training
Are you the patient?
(Required)
Yes
No
Does the patient have Medicaid?
(Required)
Yes
No
I am not sure
One MUST have MEDICAID to enroll in the CDPAP program. Medicare is NOT enough
Would you like help applying or determining eligibility?
(Required)
Yes
No
Are you looking to pay privately or with long term care insurance?
(Required)
Yes
No
Again, one is NOT eligible to enroll in the CDPAP program WITHOUT MEDICAID
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Yes, Rockaway can contact me via txt, email, or calls to provide more information
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Name
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How can we help you?
Please select one option
Signup For Home Care
Signup For CDPAP
Start Working With Rockaway
Name
First
Last
Email
Phone
Select Location(s)
(Required)
Brooklyn
Bronx
Manhattan
Queens
Staten Island
Rockland
Suffolk County
Nassau County
Westchester
Are you?
(Required)
A licensed Home Health Aide (HHA)
A licensed Personal Care Aid (PCA)
Looking for training
Are you the patient?
(Required)
Yes
No
Does the patient have Medicaid?
(Required)
Yes
No
I am not sure
One MUST have MEDICAID to enroll in the CDPAP program. Medicare is NOT enough
Would you like help applying or determining eligibility?
(Required)
Yes
No
Are you looking to pay privately or with long term care insurance?
(Required)
Yes
No
Again, one is NOT eligible to enroll in the CDPAP program WITHOUT MEDICAID
Consent
Yes, Rockaway can contact me via txt, email, or calls to provide more information
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.
