Family Caregiver Application

Image with text "Aging Services Caregiver Support"


Click Here to Download the Family Caregiver Application >>>>>> Button image with text "Download"

Dear Caregiver,

Thank you for contacting the Baltimore City Health Department Division of Aging & CARE Services, National Caregivers Support Program for assistance with your caregiving responsibilities for your loved ones. The Office of Aging & CARE Services is the primary program in the city responsible for advocating for and delivering services to older adults, their families, and caregivers in the City of Baltimore.

Enclosed you will find the forms needed to process your request for caregiver assistance. Please complete all forms and return them to our office as soon as possible. Please note that all applications are based on a first-come, first-served basis and the availability of funds.

The information contained in this application packet is legally privileged and confidential information intended for the use of this application only. If you have any questions regarding this request or have a need for assistance with other services, please feel free to contact us at (410) 396-1337 If you need assistance with your grant application, please contact Jazmine Adams or Jose Jimenez at (410) 396-1337.

Jose Jimenez
Program Administrator