Muskoka HomeCARE Plus Muskoka Homecare Plus ~ Private Homecare Services by Tina Roberts, Huntsville, Ontario  
Building memories, defining hope
Private Homecare Services

Please complete the Questionnaire below to help us determine your requirements. Due to the personal nature of these questions, feel free to phone us in confidence at (705) 789-2649. Please leave a detailed message and we will call you back as soon as we can.

On receipt of your form or detailed phone message, we will call you to discuss how we may best serve your needs. All customers must complete the confidential telephone interview prior to receiving any services from Muskoka HomeCARE Plus.

 

Please have the following information to hand:
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About Us
 

 
 
  • Your detailed medical condition
  • Your personal attendant care history
  • Your current medications and dosage

NOTE: This is not a secure site, information may be intercepted by others.

How may we best assist you?

Private Senior Care Travel General in-home Companionship
Long Term Care Shopping Appointments Day Trips

Have you been assessed by a Doctor or other Professional?

       

Where do you live in Muskoka?

Other:
 
Have you had attendant care before?

       

Enter any further comments or information you wish to share in the space provided below:

Tell us how to get in touch with you:

Name
E-mail
Tel
Please contact me as soon as possible regarding this matter.

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Copyright © 2003 [Muskoka HomeCARE Plus]. All rights reserved.
Revised: 12/01/03.
 

Muskoka HomeCARE Plus 149 Main St W, Huntsville, On, P1H 1X8   Ph: (705) 789-2649