Tell Us How We Can Help

Tell us what your loved one needs. We'll listen, assess the situation and help you determine the right level of support without pressure or obligation.

Your Information

First Name *Last Name *Phone Number *Email Address *Preferred Contact Method *Best Time to Contact *

Who Needs Care?

Who are you requesting care for? *Person Receiving Care *Age (optional)City / Community *

Services Needed

Select all that apply *

CompanionshipPersonal Care AssistanceMeal PreparationLight HousekeepingLaundryErrandsCommunity SupportAppointment SupportRespite CareOther

Other service details

Care Schedule

Preferred Start DateHow Often Is Care Needed? *Preferred Time *Approximate Hours per Visit *

Preferred Days

MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Care Needs

Please tell us about the support needed *Anything else you would like us to know?

Please do not include diagnoses, medical records, health card numbers, or financial information.

How Did You Hear About Us?

Referral Source *

Consent

I understand that Eagles Heart Home Care provides non-medical home-care services and that submitting this form does not create a care agreement or guarantee service availability. Read our Privacy Policy.

Compassionate Care. Comfort at Home. Peace of Mind.

Non-medical home-care support. We do not provide nursing, diagnosis, clinical treatment, or medical procedures.

Services

Companionship
Personal Care Assistance
Meal Preparation
Light Housekeeping
Errands & Community Support
Appointment Support
Respite Care

Contact

587-936-0780 care@eagleshomecare.ca

Spruce Grove, Stony Plain, St. Albert & Parkland County

Serving Spruce Grove & nearby communities. If your city is not listed, please contact us.

Call Request Care