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GALA – Elder Care Intake Form
Help us understand your care needs so we can match you with the right care provider or care home.
Section 1: Care Type Needed
What type of care are you looking for?
*
(Select all that apply)
Care providers (personal support workers who come to you)
Care homes (retirement, assisted living, nursing homes, inclusive later life living/community-based small homes, or respite stay)
Other
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