Contact Us

Get in touch

We’d love to hear from you! For general inquiries, please use our contact form, or for faster assistance, connect with our webchat agent.

Service Areas

Detroit Metro Area | Oakland | Wayne | Macomb | Kent | Jackson

Main Office

26677 W 12 Mile Rd.
Southfield, MI 48034

Email us

info@yesyoucan2.com

Call us

Phone: 313-922-7227

Ready to Get Started?

Female healthcare worker sitting at table smiling with a senior woman during a home health visit

Please download, complete, and fax the forms below to 855-287-5729.

Adult Services Application

The client must complete and sign a DHS Adult Services Application form to receive home help services. An authorized representative or another person acting for the client may sign the form if the client is either:

  • Incapacitated
  • Has a court-appointed guardian

A client unable to write may sign with an X, witnessed by one other person (for example, a relative or department staff).

The Medical Needs form must be signed and dated by a medical professional certifying a medical need for personal care services. 

The medical professional must be an enrolled Medicaid provider and hold one of the following professional licenses:

  • Physician (MD or DO)
  • Physician Assistant
  • Nurse Practitioner
  • Occupational Therapist
  • Physical Therapist

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