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Select Your Care Package
Full Name:
Phone Number:
Select Type of Care:
Choose an option
Basic Care
Mother & Baby Care
Chronic Disease Management
Physiotherapy & Rehabilitation
Elderly / Palliative Care
Emergency Care
Other
Select Services Needed:
🏥 Vitals Monitoring
💊 Medication Assistance
🩹 Wound Care
👶 Newborn Check-ups
🩺 Doctor Check-ups
🏃 Physiotherapy
🛌 Palliative Care
🍎 Diet & Nutrition Planning
👁️ Eye Care
🧒 Child Care
👵 Parental Care
🩺 Nephrologist Care
🏠 Occupational Therapy
🧠 Mental Health Support
🗣️ Speech Therapy
👩⚕️ Home Nursing Care
💉 Chronic Disease Care
🏥 Post-Surgery Care
🚑 Emergency Response
Preferred Caregiver:
Choose a caregiver
*Help me choose
General Doctor
Pediatrician
Physiotherapist
Occupational Therapist
Speech Therapist
Dietitian & Nutritionist
Mental Health Counselor
Home Nurse
Nephrologist
Specialist Consultant
Other
Preferred Schedule:
One-Time Visit
Daily Visits
Weekly Check-ups
24/7 Live-In Care
Additional Notes:
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