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Are you seeking care for yourself, a friend, a client, or a family member? *
Myself
Friend
Client
Family Member
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Are you looking for short-term or long-term care? *
Long Term
Short Term
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What type of care are you looking for? *
Visiting Care/Hourly Care
Live-in Care
Overnight Care
Respite Care
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How many days a week is the care required? *
1-2 days a week
3-4 days a week
5-6 days a week
Everyday a week
Other
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Which of the following do you need help with? *
Personal Care
Cooking
Housekeeping
Medication
Personal Care (washing, bathing, hair and makeup)
Companionship Care
Other
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When is the care required? *
As soon as possible
Within the next week
Within the next month
Other
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Please provide your contact details.
Name
Email
Phone Number
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How would you describe your current situation in finding a care provider? *
I'm just starting to explore my options.
I'm planning to hire a caregiver soon.
I'm definitely going to hire a caregiver.
I'm researching to find the best fit.
I'm not sure yet and need more information.
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