Your inquiry information.

What the inquiry form collects

The form asks for a name, phone number, optional email, ZIP code, general care preference, timing, payment preference, and permission to respond. A reference number, timestamp, and preview flag are stored with the request.

Professional referral information

The referral form collects the referring professional’s name, organization, email, phone number, preferred contact route, anticipated timing, and optional care city or ZIP code. With the appropriate permission, it can also collect a family contact’s name and phone number. Consent and a submission timestamp are stored. No medical records or insurance documents are requested.

Website measurement

Basic interaction hooks distinguish call clicks, care and referral buttons, and successfully saved forms. No analytics provider is connected, and these hooks do not send information to Google or another analytics service. Names, contact details and form answers are excluded from these events.

How requests and notifications are handled

Submitted details are stored in this site’s hosted database for review in the owner inbox, which requires authorized sign-in. Sites hosting and its Cloudflare-backed infrastructure operate these features. Submissions can send a minimal notification through Resend to the agency’s designated email address. The notification contains the request reference and a secure inbox link, not the form’s contact or care details. Submissions do not book or begin care.

Keep sensitive details out of this form

Please do not enter medical records, diagnoses, policy numbers, Social Security numbers, payment card details, or another person’s information without appropriate permission. This form has no document upload.

Protecting the inquiry forms

We use field validation, a hidden bot field, submission references, and request limits to reduce abuse. Short-lived counters use a hash derived from the submitted phone number and the current 15-minute period, plus an overall counter. Raw phone numbers are not stored in these counters. A hash is not a guarantee of anonymity. Expired counters are removed when another valid submission is processed.

Follow-up and retention

We use these details to review service fit, contact the authorized person, and track follow-up. Form consent is permission to respond to the inquiry, not enrollment in a marketing mailing list. A submission does not reserve a caregiver, book an assessment, or begin care.

Inquiry records are currently retained until reviewed and removed; no automatic deletion schedule is enabled. The owner can permanently remove preview tests from the website inbox after confirmation. This does not remove notification emails already sent or provider-held copies. Hosting and email providers may process operational information needed to run their services.

Questions, corrections, or removal requests

You can ask to correct information, request removal, or ask us to stop following up. We may need to confirm the identity or authority of the person making the request. Do not include sensitive records in your initial email.

Contact BprovisionsCare@gmail.com or 706-477-5960 about an inquiry you submitted.