Konnect - Optimised SQL Server systems for Non Technical People

Domiciliary Carer

If using a mobile device, please complete either Hourly or Live In care sections as required

Main Details
Are you an individual or a company ? *
Do you require hourly or live in care ? *
Specialised care required Cardiovascular disease is a group encompassing (for example, strokes, health failure, ischaemic heart disease and peripheral artery disease
Specialised Care Additional Information
Max number of responses you require *
How soon do you wish to see your responses (hours) ? *

Hourly Rate Care
How many days a week is care required ?
What type of care is required ? (you can select more than one on a desktop pc)
What medical conditions do you or the client have ?
When is the care package required ?

Live In Care
How many days a week is care required ?
Type of care required ? (you can select more than one on a desktop pc)
What medical conditions do you or the client have ?
When is the care package required ?
Does the client need monitoring at night ?

To Finish
Location for care (place,region,district,country listed) *
Your name *
Email *
Telephone (optional)
By ticking this box I give consent for my data to be used solely for the purpose of helping me receive assistance in this request. *

Multi-select options can be accessed by holding down the CTRL key and clicking on the options for pc-based users.