Online Sign Up Form

Annual Dues Statement

Kansas City Regional Home Care Association fiscal year is September 1 through August 31.  Yearly dues are $200.00 for provider members and $50.00 for Honorary/ Courtesy members.  Annual paid dues allow ONE vote as well as minutes of each meeting e-mailed to the voting member.

**Please pay dues by September 30 each year

MEMBER (Voting privileges and active participation on committees and the Board)  $200

HONORARY/COURTESY (Home Care Providers are not eligible for this membership level)  $50.00


Complete this Form to Join the KCRHCA

Name of Organization (required)

Name of Voting Member (required)

Voting Member Email (required)






Please choose the category under which your company will be listed (required):


Please select the services provided by your company:


Please select the committees you are interested in or would like more information on:


Who will be attending the monthly KCRHCA meetings? Please provide their names and email addresses below:


Administrator Email


Clinical Manager

Clinical Manager Email


Therapy Coordinator

Therapy Coordinator Email


Social Worker

Social Worker Email


Private Duty Coordinator

Private Duty Coordinator Email


Hospice Representative

Hospice Representative Email


Volunteer Coordinator

Volunteer Coordinator Email



Chaplain Email


Please be advised: Only click the “Send” button once.


Remember: Make checks payable to Kansas City Regional Home Care Association, Inc. and mail to:

Pam Holmes KCRHCA
3 S. Julie St.
Louisburg, KS 66053

New Members Only – Prorated dues after September 30th :

Oct-$187.00        Nov-$170.00     Dec-$153.00     Jan-$136.00

Feb-$119.00       Mar-$102.00     Apr-$85.00         May-$68.00

June-$51.00       July-$34.00       Aug-$17.00


Any questions, please contact us here.