Information you choose to share
Care inquiries ask for your name, phone number, general location, relationship to the person seeking support, broad service interests, timing, payment preference and permission to contact you. Partner inquiries ask for your business name, organization and phone number. Required fields are marked.
How inquiry information is used
Information is stored privately in the website database so Bethel Place can review your inquiry and discuss service suitability, location, availability and payment options. Inquiry details are not displayed publicly. If an email delivery service is configured by Bethel Place, inquiry information may also be forwarded to the designated agency recipient.
Do not submit sensitive information
Do not provide diagnoses, medical records, insurance member numbers, Social Security numbers or other sensitive health information. No documents can be uploaded through these forms. This website is not a secure clinical referral portal.
Website operation and analytics
The hosting platform may process technical information needed to operate the website, including requests and basic usage analytics. The site does not offer advertising signup, automatically send text messages or require a resident account to submit an inquiry.
Your choices
Submitting an inquiry permits contact about that inquiry; it does not enroll you in care or establish an agreement for services. You can ask Bethel Place to correct your information or stop further contact when the team calls. You may also use the care inquiry form to request a phone conversation about your information.
Contact and urgent needs
Use the care inquiry form to request contact by phone. Do not use the form for emergencies or time-sensitive assistance. For a medical emergency, call 911.