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Choose Your State
New York
Downstate NY Home Care
Upstate NY Home Care
Michigan
Missouri
About Us
About Us
FAQ’s
Blog
Home Care
Home Care
Medicaid Planning
Private Pay
Pediatrics
CDPAP
NHTD
NHTD
TBI
Work For Rockaway
Work With Rockaway
Employee Links
Keeper
Employee Referral Program
Forms
FSA Card(Melody)
Maxsip Phone Partnership
Get Verified
DME
Contact
516-239-8693
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Medical Forms
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Submit Declination
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Last
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Brooklyn
Bronx
Manhattan
Queens
Staten Island
Rockland County
Suffolk County
Nassau County
Westchester County
Dutchess County
Orange County
Putnam County
Ulster County
Sullivan County
Are You?
(Required)
A licensed Home Health Aide (HHA)
A licensed Personal Care Aid (PCA)
CDPAP - I have a family member I want to care for
Looking for training
Are You The?
(Required)
Patient
Family
Friend
Other
Does the patient have Medicaid?
(Required)
Yes
No
I am not sure
What Is The Patients Medicaid Number?
Medicaid numbers should be in AB12345C format.
One MUST have MEDICAID to enroll in the CDPAP, NHTD And Homecare programs. Medicare is NOT enough
Would you like help applying or determining eligibility?
(Required)
Yes
No
Are you looking to pay privately or with long term care insurance?
(Required)
Yes
No
Again, one is NOT eligible to enroll in the CDPAP, NHTD or Homecare programs WITHOUT MEDICAID
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Consent
Yes, Rockaway can contact me via txt, email, or calls to provide more information
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How can we help you?
Please select one option
Signup For Home Care
Signup For CDPAP
Signup For NHTD
Signup for Private Pay
Start Working With Rockaway
Name
First
Last
Email
Phone
Select Location(s)
(Required)
Brooklyn
Bronx
Manhattan
Queens
Staten Island
Rockland County
Suffolk County
Nassau County
Westchester County
Dutchess County
Orange County
Putnam County
Ulster County
Sullivan County
Are You?
(Required)
A licensed Home Health Aide (HHA)
A licensed Personal Care Aid (PCA)
CDPAP - I have a family member I want to care for
Looking for training
Are You The?
(Required)
Patient
Family
Friend
Other
Does the patient have Medicaid?
(Required)
Yes
No
I am not sure
What Is The Patients Medicaid Number?
Medicaid numbers should be in AB12345C format.
One MUST have MEDICAID to enroll in the CDPAP, NHTD And Homecare programs. Medicare is NOT enough
Would you like help applying or determining eligibility?
(Required)
Yes
No
Are you looking to pay privately or with long term care insurance?
(Required)
Yes
No
Again, one is NOT eligible to enroll in the CDPAP, NHTD or Homecare programs WITHOUT MEDICAID
Privacy Policy
Consent
Yes, Rockaway can contact me via txt, email, or calls to provide more information
CAPTCHA
This field is hidden when viewing the form
utm_source
This field is hidden when viewing the form
utm_medium
This field is hidden when viewing the form
utm_campaign
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utm_term
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utm_content
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gclid
Name
This field is for validation purposes and should be left unchanged.
