Service Information

Short Stay Respite: Central Registry Intake
Organization: Central Registry > Nucleus Independent Living
Description:

Provides assistance in connecting clients with a variety of services from local community agencies. Services include out-of-home caregiver respite.



Requested period of stay (max 2 weeks)
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Are these eligibility requirements met?

Care Recipient does not require 24 hours supervision.
Care Recipient is agreeable to Short Stay (daily
intermittent care).
Care Recipient does not pose a risk to self or others.
Care Recipient does not require specialized behavioural care or
mental health support (physically combative, verbally
abusive etc.).
Care Recipient does not require a locked care facility.
Minimum Age: 18 yrs
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Care Recipient Information

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What is the preferred Language?

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Is an interpreter required?

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Primary Caregiver
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Email (Confirmation and reminder emails will be sent here)

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Lives with Care Recipient?

What is the preferred Language?

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Is an interpreter required?

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Referral Source
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Health Information
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Please list and describe any allergies

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Additional Information

Attach RAI and other applicable documents here.

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Send confirmation, change & reminder messages to < name > < email >

Submission complete

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Summary

Reference #: -
  • Registrant:
  • Organization:
    Central Registry > Nucleus Independent Living
    Service:
    Short Stay Respite: Central Registry Intake
    Inquiry Phone:
    1 (905) 281-4443

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