All Vitalis HealthCare forms are available online for caregivers, clients, and families. Use the links below to submit reports, requests, and referrals directly to the Vitalis administration team.
Caregiver & Staff Forms
Incident Report Form
Use this form to report any significant events that need to be brought to the attention of the Agency administration — including falls, injuries, abuse, or any unusual occurrences during a shift.
Illness / Infection Report Form
Use this form to report any illness or infection experienced by a client or caregiver during the course of care. Prompt reporting helps us protect everyone involved.
Leave / Absence Request Form
Caregivers — use this form to call out of a shift, request a leave of absence, or submit your 2-week notice upon resignation. Please submit this form as early as possible so we can arrange coverage.
Complaint Form
Vitalis Complaint Form
Use this form to register a complaint about the quality of service being rendered by a Vitalis caregiver. All complaints are reviewed by our Client Services team and handled promptly and confidentially.
Referral Forms
Refer a Client
Do you know someone who needs home health care in Maryland? Use this form to refer a potential client to Vitalis HealthCare or to learn about our client referral program.
Refer a Caregiver
Do you know someone looking for work as a home health aide in Maryland? Use this form to refer a potential caregiver to the agency or to learn about our staff referral program.
Need Help?
If you have trouble accessing any of these vitalis healthcare forms or need assistance, contact us directly:
Phone: 240.716.6874 Email: team@vitalishealthcare.com WhatsApp: Message us
Our team is available Monday–Friday 9am–5pm and Saturday 10am–4pm.