Contact us Independent @ Home Consumer Directed Personal Assistance Program Call Us 1-800-234-2211 Address1050 West Genesee Street Syracuse, NY 13204 I@H Contact Us I am: * interested in having a Personal Assistant care for me interested in becoming a Personal Assistant wanting to report a grievance Please use the form below to report suspected Medicaid Fraud, CDPAP program fraud or sexual harassment. Please be sure to provide as much detail as possible so we can accurately and promptly follow up on the claim made. Name: * Name: First First Last Last County: Albany CountyAllegany CountyBroome CountyCattaraugus CountyCayuga CountyChautauqua CountyChemung CountyChenango CountyClinton CountyColumbia CountyCortland CountyDelaware CountyErie CountyEssex CountyFranklin CountyFulton CountyGenesee CountyGreene CountyHamilton CountyHerkimer CountyJefferson CountyLewis CountyLivingston CountyMadison CountyMonroe CountyMontgomery CountyNiagara CountyOneida CountyOnondaga CountyOntario CountyOrleans CountyOswego CountyOtsego CountyRensselaer CountySaratoga CountySchenectady CountySchoharie CountySchuyler CountySeneca CountySt. Lawrence CountySteuben CountyTioga CountyTompkins CountyWarren CountyWashington CountyWayne CountyWyoming CountyYates County Do you already know who you want to care for you? * Yes No Do you already know who you want to care for? * Yes No Name of person you want to care for: * Name of person you want to care for: * Do you have Medicaid? * Yes No Not sure Does the person you want to care for have Medicaid? * Yes No Not sure Please contact me by: * phone email Phone number: * (include area code) Email address: * Message: Message: * * By checking this box, you give consent for Independent @ Home to contact you and/or your representative about enrollment in its CDPAP program. If you are human, leave this field blank. Submit
