Enhanced Listing Form for Care Homes or Care Homes with Nursing

CONTACT INFORMATION:

(Please input information as you want it to appear on the website)

Company/Home name*:

Address:

Postcode:

Owner:

Person in charge:

Job title:

Telephone:

E-mail*:

Website:

Care Select Member

YOUR DESCRIPTION:

IMAGES:

Logo:
Please send a high resolution Jpeg or EPS of your company logo. (10MB Max)

Please send your logo to lisa.werthmann@carechoices.co.uk via WeTransfer.

Photographs:
Please send a maximum of 5 images, as high resolution Jpeg or Gif. (10MB each Max)

Please send your images and any valid Licences for commercial use to lisa.werthmann@carechoices.co.uk via WeTransfer

  Please supply details of your image licences:

or

I confirm no valid licence for commercial use is required for the Photograph(s) I am supplying

PLEASE NOTE: The customer must have a valid licence for commercial use for all supplied imagery (including photographs) The valid licence must be supplied to Care Choices for checking. The customer indemnies Care Choices against any licence infringement. Care Choices has the right to recover all costs, expenses, damages, losses and other liabilities (including but not limited to all legal costs) suffered or incurred by Care Choices.

I Accept/Understand the above disclaimer.

ACCOMMODATION:

Number of private bedrooms:

Single

Double

Total ensuite bedrooms

Total regular bedrooms

Number of lounges or seating areas:

Hobby rooms:
YesNo

Residents may bring:

Rooms have:

Building type:

Lifts:

Wheelchair access:

Outdoors:

Details of any associated housing, extra care or close care.

WEEKLY COST

Personal care (From)

Nursing care (From)

LIFESTYLE:

Pets:

Decision making:

Smoking:

Daily routines are:

Meals:

Family and friends:

CULTURE AND RELIGION:

If the home is suited to particular groups of people, please describe:

Special requirements addressed?:

Languages spoken:

ACTIVITIES:

How often are activities organised?

LOCATION:

Location type:

Distance to Local shop: (yards/miles)

Distance to GP: (yards/miles)

Distance to Bus stop: (yards/miles)

Distance to Town centre: (yards/miles)

REGISTRATION AND SPECIALISMS:

Number of Beds

Care only:

Nursing:

Domiciliary Homecare:

Supported living:

Year registered:

Year built:

Registration categories:

Care specialisms:

Care for people who need:

Can usually accept people with:

and/or people who:

Duration of care:

Please enter the value of sums into the box below:

* Please check you have ticked all required boxes before submitting.