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Request a Free Respite Care Consultation

Complete the form below and a member of our care team will contact you shortly to discuss your needs, answer your questions, and help you explore the most appropriate care options.

Tell Us How to Reach You

Please provide your contact information and a member of our care team will reach out to discuss your care needs.
Name

Tell Us About Your Situation

Help us understand your caregiving needs so we can recommend the most suitable respite care options.
What is happening right now that makes respite care feel necessary for your family? (Choose all that apply)
When NtongoCARE is with your loved one, what support must continue so they remain safe, calm, and comfortable at home? ( (Choose all that apply)
What would a successful respite care plan achieve for you over the next few weeks or months? ( (Choose all that apply)
Safety Flags / Risks

A Few Final Details

Provide any additional information that may help us understand your needs.
Consent
By submitting this form, you consent to NtongoCARE collecting and using your personal information solely to provide dementia care consultation and services. We comply with Ontario’s Personal Health Information Protection Act (PHIPA). Your information will not be shared with third parties without your consent, except as required by law. You may withdraw consent at any time.

Need Immediate Assistance?

Our care team is available to discuss your situation and answer questions about dementia care services.