Adult Respite

BECOMING AN ADULT RESPITE CAREGIVER - EXPRESSION OF INTEREST

Please enter the letters or numbers exactly as they appear.

Name

Address

Home Phone

Cell Phone

Email

Please indicate which of the following respite options are of interest to you?

In Home Respite (Provided in your personal home or the home of the individual)

Community Respite (Provided in the community; typically involves engaging in various activities)

Emergency Respite (Individuals are placed into screened safe homes; usually short term)

Please describe your experience supporting adults with disabilities.

Do you have any contractual or service relationships with either of the organizations below?

CLBC

LACL

Please share some of your interests and hobbbies.

When would you be available to begin providing respite supports?

Click SEND to submit your application.

Head Office:
23535 - 44th Avenue
Langley, BC, V2Z 2V2

Office Hours:
8:00 am to 4:00 pm
Monday to Friday

Phone: 604-534-8611
Fax: 604-534-4763
[email protected]

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