ClickHealth

ClickParentsCare On-Boarding Form

This form is to onboard CareOverseer, CareReciever and CareGiver to ClickParentsCare service

(Individual subscribing to the service for their parents and other senior members in the family back home in Bangladesh)

First Name*

Last Name

Email*

Phone*

Preferred Mode of Communication (Platform where you'd like to receive updates on a regular basis)

Messenger

Viber

Signal

Other

Address *(Address of the CareOverseer)

Country

Who you like to add additional CareOverseers?

Yes

Number of CareRecievers*

Number of Senior members in a family for whom the care service is availed by their son/daughter/relative living abroad.