Home Healthcare Services Contact Form

Complete the Online Home Care Contact Us Form

Peconic Landing is here to support you in navigating your home healthcare needs. We will help you explore available care options while allowing our team to gain an understanding of your individual needs.

Once you’ve completed the form, a member of our team will review and reach out to discuss our services and answer any questions you may have.

Name(Required)

First Last

Email(Required)

Phone(Required)

Address Where Services are Needed(Required)

City State / Province / Region ZIP / Postal Code

Mobility

Difficulty with stairs

Unsteady walking or prone to falls

Trouble getting in and out of bed

Memory Loss

Frequently missed appointments or commitments

Trouble communicating or forgetting conversations

Disorientation with time, places or people

Household Management

Neglects or is unable to clean the home

Accumulation of mail or newspapers

Difficulty paying bills on time

Personal Hygiene

Difficulty with bathing

Challenges with grooming or dressing

Additional Information

Please let us know what's on your mind. Have a question for us? Ask away.

Let us assist you in finding the right level of care to ensure comfort, safety and peace of mind at home. Have immediate questions? Please call Peconic Landings Home Healthcare Services Administrator at 631-477-2146. By submitting this form, you agree to be contacted by a member of the Peconic Landing team. View Privacy Policy.

Give us a call

631-477-2146

Get in touch

scroce@peconiclanding.org

Visit us

1500 Brecknock Road
Greenport, NY 11944

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