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Intake Form: Find Your Appointment Companion

How LociLink Works:
Step 1: Share Your Appointment Details

Tell us about your upcoming procedure, the clinic location, and the level of support you need. Whether it’s a mandatory sedation companion or a second pair of ears for doctor’s notes, we’ve got you covered.

Step 2: Meet Your Potential Matches

We don’t just assign a random name. We check our registry of vetted, background-checked local "Pals"—primarily nursing students and healthcare professionals—to find those who are available and a great fit for your specific needs. We’ll introduce you to an available Pal who is ready to support you.

Step 3: Confirm & Connect

Once you and your Pal are both ready to move forward, you pay a $25 Locilink Match Fee to secure their time. We then connect you via WhatsApp to coordinate meeting at the clinic entrance. After the visit, you pay your Pal their hourly rate ($25–$35/hr) directly.

Let's start with your personal details

What is your appointment date?

What is your appointment time?

What is the clinic location?

What type of support do you need?

What type of support do you need?

LociLink's "No-Driving" Rule: I understand the Pal meets the patients at the appointment site and will not drive the patient to or from the appointment.

LociLink's "No-Driving" Rule: I understand the Pal meets the patients at the appointment site and will not drive the patient to or from the appointment.

Payment Acknowledgement: I agree to pay the $25 Locilink match fee and pay the Pal's hourly rate directly via Venmo/Cash/Paypal

Payment Acknowledgement: I agree to pay the $25 Locilink match fee and pay the Pal's hourly rate directly via Venmo/Cash/Paypal