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Happy Patient

PATIENT FORM

PATIENT

Private Pay Agreement

Beyond Health Co. LLC dba Beyond Home Health Care requires a two-
week deposit to start service for all private pay clients. Beyond Home
Health Care bills every week for service and payment is expected within 10
days of the billing date.

Deposit and/or Payment Options include the following

Hourly rate:
Hours per week

Please note that both interest and late penalties are assessed to individuals not paying on time. In the event of non-payment Beyond Health Co. LLC dba Beyond Home Health Care has the right to terminate and cancel all services.


Beyond Home Health Care requires 10-day notice be given, to the office, to either end or change the working hours for a caregiver. Please be sure to contact the office as soon as either situation arises. In addition, Beyond Home Health Care may also request additional deposit (than the original 2 weeks) if hours for the case have changed during the course of care.

Thanks for submitting!

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Sunday
Monday
Tuesday
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Saturday

Closed
9AM–5PM
9AM–5PM
9AM–5PM
9AM–5PM
9AM–4PM
Closed

Contact Info

(412).223.3700

4 Smithfield Street
Ste 11G
Pittsburgh, PA 15222

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© 2024 by Beyond Home Healthcare.

All Rights Reserved.

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