Care Enquiry

Please complete the information requested in the form below and one of our experienced Care Managers will contact you by return to discuss how Hales Health and Social Care can fulfil your requirements.

Contact Details
Title*	Mr Mrs Miss Ms
First name*
Surname*
Daytime Telephone*
Other Telephone
Address
Postcode

Please tick the relevant statement
I am enquiring in regards to care for myself
I am enquiring in regards to care on behalf of another
I am the owner/manager of a care service and enquiring about supply to my service

Please tick the services you are interested in.
Older People
Learning disabilities
Physical disabilities
Mental Health
Children
Personnel care
Companionship
Live in care
Hospital Discharge
24 hour care
Convalescents
Medication support
Social support
Healthcare support
RGN's/RMN's
Permanent care staff
Ad hoc care staff

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