Reserve My Spot Secure your spot in our supportive, caring community Join Our Humble Hands Waiting List Please enable JavaScript in your browser to complete this form.DemographicsName *FirstLastAge Range *18–2425–3435–4445–5455-6465-7475+Please specify your gender *LayoutGender *FemaleMaleTransgender femaleTransgender maleNon-binary/non-conformingPrefer not to respondOtherOccupation/Former Occupation *Marital Status *MarriedSingleSeparatedDivorcedWidowedContact Information *PsychographicsInterests and Hobbies *Values and Beliefs *Main Concerns/Fears *Goals/Aspirations *Social Interaction interests *Health and Care NeedsCommon Health Conditions/Disabilities *What type of care is needed? *For example: Daily activity assistance, bathing, eating, dressing etc.Dietary Preferences/Restrictions *Medications/Treatments *Assistive Devices used Daily *Facility PreferencesWhat type of living arrangements are preferred? *PrivateSemi-PrivateWhat amenities are important to you? *For example: Fitness center, library, beauty shop, etc. Financial ConsiderationsWhat is your budget for assisted living? *Please specify the amount you are comfortable paying monthly.Financial Options for above budget? *For example: Retirement funds, insurance etc.Join Our Priority Waiting List! Be among the first to experience assisted living with Humble Hands. LayoutEmail *PhonePreferred Move-in Date *Additional Comments (if any)Reserve My Spot Care & Respect Your Trusted Choice for Assisted Living. Contact 929-242-6868 support@humble-hands-llc.com Facebook Twitter Youtube Location 125 Fifth Avenue, New York, NY 10160
