Senior Call Check Form -Check In
Thank you for contacting the Senior Call Check program. You can use this form to verify your daily check in call, in the event you missed your 3 automated calls.  If you missed your automated call within an hour of your daily time frame, you can call 1-855-765-3148 to verify your call.  

We are also available by phone Monday through Friday 8 am -5 pm and Saturday 9 am -3 pm. During these hours, seniors can call toll-free 1-866-50-CHECK (1-866-502-0560). Please note, Senior Call Check phone lines and robocalls are closed New Year’s, Memorial Day, 4th of July, Labor Day, Thanksgiving and Christmas.

The form responses will be monitored daily between the hours of 8 am and 4 pm, excluding holidays.
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I missed today's robocall and would like to confirm I am doing well. There is no need to call my alternate. *
First and Last Name *
Please provide the phone number we call you on daily *
Please provide your email
Please provide any additional feedback and please notate if you would like someone to follow-up with you.
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