Home Care Council of PA — Founding Membership Enrollment

Home Care Council of PA — Founding Membership Enrollment

Join a professional community created for Pennsylvania non-medical home care agency owners, administrators, and agency leaders. Complete the information below to enroll your agency as a Founding Member.
Who This Membership Is For
Home Care Council of PA is a professional community for Pennsylvania non-medical/non-skilled home care agencies and the owners, administrators, and agency leaders responsible for operating them. This membership is not intended for Medicare-certified skilled home health agencies providing skilled nursing, therapy, or other skilled home health services.
Agency & Member Information
First Name
Last Name
Agency Name
Title / Position
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Agency Street Address
City
State
ZIP Code
Pennsylvania County / Service Area(s)
Select all counties your agency currently serves.
Agency Website
PA Department of Health Home Care Agency License Number
I understand that Founding Agency Membership is $99 per month per agency beginning February 2027 and automatically renews monthly until canceled. I understand that the January 15, 2027 Inaugural Meeting is complimentary and separate from paid membership. I acknowledge that Home Care Council of PA provides professional education, information, resources, and peer discussion and does not provide legal advice or guarantee regulatory compliance.
Authorization
Electronic Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Founding Agency Membership

Home Care Council of PA Founding Agency Membership

$99.00 for each month

Debit or Credit Card
Credit Card Number	Security Code
Expiration Month	Expiration Year

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Home Care Council of PA — Founding Membership Enrollment

Who This Membership Is For

Agency & Member Information

Authorization

Founding Agency Membership