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Jakoma Home Tech Enquiry

Need practical support to help an older relative stay safer and more independent at home?
Complete this short form and Jakoma will get back to you to discuss your situation and whether we can help.
Service area: Banbridge + 30 miles. Important: This is a practical technology setup and guidance service. It is not medical care, clinical monitoring, emergency response, 24/7 monitoring or a substitute for professional care.

Contact details

Full Name

Email Address

Phone number

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Best time to contact you

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About the enquiry

Who is this enquiry for?

Who is this enquiry for?
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What town or postcode is the property in?

Is the property within Banbridge + 30 miles?

Is the property within Banbridge + 30 miles?
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Main concerns

What are the main concerns?

What are the main concerns?
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Please briefly describe the situation

What level of support are you considering?

What level of support are you considering?
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Next step

What are you hoping for help with?

What are you hoping for help with?
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How did you hear about Jakoma?

How did you hear about Jakoma?
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Anything else we should know?

Consent checkbox

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