+1 (647) 969-2982

Request a Home & Daily Living 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 Care Needs

Help us understand the type of assistance that may be required.
What home tasks are becoming difficult? (Tick all that Apply)
What home or daily living tasks are becoming difficult, unsafe, or overwhelming right now? (Tick all that Apply)
What is making these daily living tasks harder to manage? (Tick all that Apply)
What would a successful daily living support plan help achieve over the next few weeks or months? (Tick all that Apply)

A Few Final Details

Tell us more about the situation so we can recommend appropriate care options.
Which areas are currently the most challenging?
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.