Client Registration Client Full Name Email Client Description Date of birth Country of Birth Gender Male Female Other Worker's Gender Preference Male Female Other Languages You Speak Phone Number Post Code Services You Need (Hold Ctrl while selecting) Personal Care Domestic Assistance Social Support Massage Therapy Transport Manual Handling (Lifting, Transfers) Anaphylaxis (Severe Allergic Reaction Allergies (Any substance that support worker avoid) Epilepsy or Seizures (any medication to control) PEG Feeding (Feeding on any tube nutrition) Catheter Care (Any urine drainer You Use) Medication Management (Supervision of medication Mealtime Management (Help eating on a time) Swallowing & Nutrition (Difficulty in swallowing or risk of choking) Bowel Care (Interventions to maintain a healthy bowel) Diabetes Management (Cheaking suger levels regularly) Behaviour Management (Positive and Productive support) Asthama ( medication or affected airways) Mental Health (If need psychosocial disability support) Other (Not mentioned here) Disability type Support Hours Per Week You need 0-5 6-10 11-15 16-20 21-25 26-30 30+ Submit
