Home care worker: Your trust is our commitment

The questionnaire - Your first step towards becoming a home care worker

We would be happy to send you a personalized offer for your 24-hour care and senior care services.

The questionnaire helps us to match you with a home care support service that suits you.

Of course, we treat all information strictly confidentially. Your data is sent to us via secure SSL encryption and is therefore reliably protected from misuse.

Salutation

First name

Surname

Postcode, location

Street, house number

Phone number

I can be best reached at:

Date

Time

Information about the person requiring care

First name

Surname

Date of birth

Postcode, location

Street, house number

Phone number

Communication possible

Care grade

requested care levels

General situation

Getting up / going to bed

Lining in and out

Walking and standing

Toilet passage

Food intake

Other diseases / diagnoses

Character and nature (e.g., cooperative, impatient, etc.)

Popular hobbies and interests

Desired start date

Estimated duration of the deployment

Requirements for the nursing staff

Gender

Driving licence

Smoker

German language skills

Desired activity of the household helper

Manage the household budget

For example, shopping, cooking, doing laundry, cleaning

Body care

e.g. washing, showering, bathing, tooth care, combing, shaving, going to the toilet

Nutrition

e.g. preparing food in a way that is easy to swallow, eating the food

Mobility

e.g. getting up / going to bed, getting dressed and undressed, walking, standing, leaving the apartment

Additional wishes

Making a contribution to society

For example, playing cards, reading aloud, going for walks, accompanying

Nightly Deployment

Nursing staff

Apartment

Number of persons living in the household of the person in need of care

Do you have pets?

If so, which ones?

Is there a private room available for the household help?

Nursing service

Will an ambulant nursing service be used?

If so, what activities does the care service undertake?

Should the care service continue to be used?

How did you become aware of us?

DSGVO consent

I agree that my information from the contact form will be collected and processed in order to answer my request. The data will be deleted after your request has been completed. Note: You can info@wicare24.com revoke your consent at any time for the future by email. Detailed information on how user data is handled can be found in our privacy policy.

Barbara Dabrowska

Take advantage of free advice now!

Are you interested in senior care or 24-hour home care? Contact us directly for a free consultation!

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