Client Information Form
This form was designed to get some basic details from you, a representative or a referral.
Once you have submitted this form, a representative from Caring Lotus will be in contact with you to discuss your needs in a little more detail and walk you through the rest of our intake process.
If you have any issues completing this form, please do not hesitate to get in contact with one of our friendly representatives by calling (03) 7036 1516 so that they can complete it for you over the phone with you.