Let's get started!

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Welcome.

You are here because you are either carrying a lot or feeling weighed down just thinking about it all.

Whether you're caring for a parent day to day, making decisions from afar, or just sensing that a shift is happening...you don't have to figure this out all alone.

This form helps us understand where you're starting from, so we can meet you there, with the right kind of support.

Take a deep breath. You're doing something brave. Let's begin.

First name?

Last Name?

How would you describe your current experience?

A

I’m still figuring it out. I’m not even sure if “caregiver” is the right word for me — but I can feel something changing.

B

I know I’m a caregiver now, but I feel overwhelmed. I’m behind on what needs to happen, and I don’t even know where to start.

C

I’ve been at this a while. I’ve put some systems in place — but it’s still hard to manage everything, and I want to feel steadier.

D

I’m getting more intentional. Things feel mostly steady, and I’m ready to start putting plans and systems in place — not just reacting.

Which parts of caregiving feel like they fall on you right now? (Check all that apply)

Most people do a mix of things - this helps us understand how you re showing up day to day.

Which parts of caregiving feel like they fall on you right now? (Check all that apply)

Which parts of caregiving feel most challenging for you right now? (Check all that apply)

No pressure to be exhaustive - this helps us spot where extra support might make a difference.

Which parts of caregiving feel most challenging for you right now? (Check all that apply)

How confident do you feel about managing the practical side of caregiving?

A

I don’t know where to start

B

I’ve started putting pieces together, but I feel behind

C

I have some systems in place, but it’s still hard

D

I’m getting more organized and proactive

E

I feel mostly steady, but always open to support

What kind of support are you initially looking for? (Check all that apply)

What is the best email to reach you?

Is there anything else you'd like to share with us right now?

Optional Demographics Section

These next few questions are optional. Your answers help us frame Kapwa AllCare support appropriately. We ask because caregiving doesn’t happen in a vacuum — your culture, identity, and lived experience shape what support feels helpful.

What is your race or ethnicity? (Check all that apply)

If you're Filipina/o/x, you're often grouped under Asian or Asian American--but feel free to self-describe if that doesn't fully reflect how you identify.

What is your race or ethnicity? (Check all that apply)

How would you describe your race/ethnicity?

Gender

A

Female

B

Male

C

Non-binary

D

Prefer not to answer

E

Other

Other (Describe)

How old are you?

A

18-24

B

25-29

C

30-34

D

35-39

E

40-44

F

45-49

G

50-54

H

55-59

I

60-64

J

65 and above

Let's get started!

Welcome.

You are here because you are either carrying a lot or feeling weighed down just thinking about it all.

Whether you're caring for a parent day to day, making decisions from afar, or just sensing that a shift is happening...you don't have to figure this out all alone.

This form helps us understand where you're starting from, so we can meet you there, with the right kind of support.

Take a deep breath. You're doing something brave. Let's begin.

First name?

Last Name?

How would you describe your current experience?

Which parts of caregiving feel like they fall on you right now? (Check all that apply)

Which parts of caregiving feel most challenging for you right now? (Check all that apply)

How confident do you feel about managing the practical side of caregiving?

What kind of support are you initially looking for? (Check all that apply)

What is the best email to reach you?

Is there anything else you'd like to share with us right now?

Optional Demographics Section

These next few questions are optional. Your answers help us frame Kapwa AllCare support appropriately. We ask because caregiving doesn’t happen in a vacuum — your culture, identity, and lived experience shape what support feels helpful.

What is your race or ethnicity? (Check all that apply)

How would you describe your race/ethnicity?

Gender

Other (Describe)

How old are you?

Thank you.

Just by filling this out, you’ve taken a meaningful first step.

The beginning of any journey isn’t just about knowing where you’re going. it’s also about recognizing where you are.

That’s what you’ve done here.

We’ll follow up soon with support that’s rooted in where you are right now.

You’re not in this alone anymore.