Family handout
PASSPORT Application Prep Checklist
PDF · 1 page · Branded · Print-ready
What families should gather before the Area Agency on Aging assessment. Useful leave-behind for PASSPORT-eligible referrals.
Want this co-branded for your team?
Call 419-704-0316 and we'll send a version with your unit, agency, or hospital floor on it. No charge.
More in Family handout
Related documents
Family handout: after referral
Plain-English handout for families. Hand at discharge so the family knows exactly what to expect after a professional refers them to Reliance.
OpenFamily discharge packet
Family-facing discharge packet to send home with the patient. Pairs with the 72-hour clinical checklist.
OpenRespite request letter
Template families send to their SSA or care manager to formally request additional respite hours. Helps DODD and PASSPORT cases.
OpenGot a referral ready?
Same business day response. A real coordinator on the phone, not a queue.