Ask about a day centre place, respite care or help at home, for yourself or someone you care for.
For your confirmation.
Helps us check we cover your area.
A few lines is plenty. We'll talk it through properly when we call.
For example, any conditions such as dementia or Parkinson's, what a good day looks like, or what's been difficult lately.
For example, uses a wheelchair, diabetic diet, hard of hearing.
We'll confirm what's available when we speak.
Leave blank for as soon as possible.
Sending this doesn’t commit you to anything. We’ll talk it through with you first.
