Carers Association of SA - Free Carers Kit

Free Carer Support Kit

58 King William Road, Goodwood, South Australia 5034
Telephone (08) 8271 6288 Fax (08) 8271 6388 Toll Free 1800 815 549

We regret this service is available to South Australian Residents only.

Request form

PLEASE FILL IN THE FOLLOWING.
Your details will remain confidential
I would like a Free Carer Support Kit
Name of Carer (Person who provides care)	*
Preferred language
Age
Gender	Male Female
Address
Street	*
Suburb	*
State	South Australia
Postcode	*
Telephone	( )
Facsimile	( )
E-mail
Are you a war veteran?	Yes No
Medical condition/s of the person cared for
Age of the person care for
Gender of person cared for	Male Female
What is your relationship with the person care for? (Are you the person's daughter, parent, husband, etc)
If the person you care for is not living with you, what is their suburb/location?
Could the Carer Advisory Service contact you to learn more about your caring role?	Yes No

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©1998,1999.Carers Association South Australia Inc. Site created by Pasquale Portaro Graphic Design
This Page Last Updated: 14 September 2002 By: webmaster

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The information contained on this site is provided for the purpose of disseminating information about the functions and activities of the Carers Association of SA Inc.

To the extent permitted by law, the Carers Association shall not be liable in relation to any loss or damage incurred by the use/or reliance upon information contained on this site.

Mention made of any service or product on this site is for information and does not constitute a recommendation either implied or expressed by the Carers Association of SA Inc.