Sign Up · Step 3 of 4 — the family form
Sign up your family
Hold your family’s place on the Delmarva Family Care interest list. We will contact families in the order they signed up.
Now forming in Delaware
Delmarva Family Care is now forming in Delaware. We are not yet a licensed Delaware Personal Assistance Services Agency or an enrolled Delaware Medicaid provider, and we are not yet providing care services. Signing up is free, holds your place on our interest list, and is not a promise of employment or services. When licensing and enrollment are complete, we will contact families and caregivers in the order they signed up.
Before you fill this in — the complete requirements
This short form only holds your place; it never asks for a Medicaid number, a Social Security number, or a date of birth. Enrollment itself has real prerequisites for the person receiving care — the Medicaid money test, the care assessment, authorized hours. Read the complete family requirements on the Sign Up page — each one explained, with its government source. You can fill in this form first and read them after; your place is held either way.
