Need to Find a Caregiver? We're Ready to Help

Please fill out the form to submit your family profile. A homecare specialist will contact you within 24 hours.

Family Profile Information

























    Services Required

    Please check all that apply. Housework can include cleaning, shopping and food preparation, driving, and/or household administration.

    Child careSenior careDisabled/SpecialDocumentationHomecare services



    Driving Requirement *

    Will the caregiver be required to drive as part of homecare duties?


    HomeCare Days /Week *

    Please indicate the # of days/week when homecare will be required.


    Days Off

    Please indicate the days (if any) when you will need no homecare.

    MondayTuesdayWednesdayThursdayFridaySaturdaySunday

    Family Vacations *

    Would the caregiver be required to accompany your family on vacation?


    Daily Homecare Hours *

    Please indicate average or typical # of homecare hours required per day.


    Caregiver Wages *

    Please indicate the gross HOURLY wages you are willing to pay a caregiver, not including benefits (approximately 10% of salary for the Employer's portion of Unemployment insurance premiums and Canada Pension Plan premiums).


    Desired Start Date *

    Please indicate approximate date, +/- 1 week if possible.


    Home Type *


    # Of Bedrooms *

    Live-in caregivers must be provided their own room.


    Children or Care Recipient

    List names, ages and gender of children/care recipients in the home.


    Household Pets

    If any, please indicate.


    Smoking Allowed in the Home? *

    YesNo

    Pregnancy

    Expecting?

    YesNo

    Pregnancy Due Date

    Please approximate


    Lifting / Weight Requirement

    If lifting is required for senior or disabled client, please indicate person's weight.


    Meal Preparation

    BreakfastLunchDinnerSnacks

    Household Services

    Please indicate any expectations for the caregiver to perform household duties as part of their work. If none, please go to "Your Name"

    Bathroom Clean UpBedroom Clean UpHousehold Care of PlantsHousehold Care of PetsGeneral CleaningGrocery ShoppingRun Household ErrandsVacuumingLaundryIroningDustingSetting TableEntertaining

    Care Requirements

    If the caregiver will be responsible for children please go to "Infant Care Requirements" or "Child Care Requirements"


    Activities of Daily Living Support

    Please check all required duties to be provided by the caregiver.

    DressingBathingToiletingCompanionshipMeal PreparationRun Household ErrandsMedication AdministrationAccompany to Activities/Appts

    Other Activities of Daily Living Support


    Infant Care Requirements

    Please check all required duties to be performed by caregiver.

    FeedingDressingReadingBathingToy Pick UpChange DiapersPrepare Baby FoodNursery Clean UpWalk Children in Stroller

    Other Infant Care Requirements


    Child Care Requirements

    Please check all required duties to be performed by caregiver.

    Bedroom Clean upDressingMealsPlay with ChildrenReadingTake to School/Activities

    Other Child Care Requirements


    Special Care Required

    Please indicate if care recipients require any special care.