1. Are you a Veteran or the surviving spouse of a Veteran that was honorably discharged?

2. Did the Veteran serve at least 90 consecutive days of active duty, with at least one day during a War time period? (Any one of the wars below) (If yes, please circle applicable wartime period)

3. If surviving spouse, were you married to the Veteran at time of death? (never divorced)

a. Did you remain unmarried after Veteran’s death?

4. Does the Veteran or Surviving Spouse need assistance with Activities of Daily Living? (please circle) (Bathing, Dressing, Transportation, Incontinence, Housekeeping, Laundry, Cooking, Meal Prep, Shopping)

Since you are a Veteran/Surviving Spouse, the VA also looks at income and assets to determine eligibility. Can you please tell me if your…

5. Assets are less than $80K? (excludes car & home)

If you answered yes to the pre-qualification questions, please submit your referral!
To:info@qlifehomecareinc.com