Home Care Stress Check

1
Which type of home care funding do you currently receive?* This field is required.
Support at Home / Home Care Package
Commonwealth Home Support Program (CHSP)
I'm not sure
2
Over the past month, how often have you felt mentally exhausted by your home care situation?* This field is required.
Never
Occasionally
About once a week
Several times a week
Almost every day
3
Which of these has been taking up the most space in your mind lately? (Select up to 3)
Trying to understand my funding
Chasing my provider for updates
Preparing for an assessment or reassessment
Keeping track of appointments
Managing medications or health changes
Organising equipment or home modifications
Coordinating family members
Worrying that I'm not getting the support I need
I don't know where to start
Something else
4
When you think about your current provider, which statement feels closest to how you feel?* This field is required.
I feel well supported.
They're generally good, but I have to follow things up.
Communication could be much better.
I often feel like I'm managing everything myself.
I'm considering whether it's time for a change.
5
How confident are you that your provider really understands your situation?* This field is required.
Completely confident
Mostly confident
Somewhat confident
Not very confident
I'm not sure
6
When something changes with your health, how confident are you that someone will help you work out what to do next?* This field is required.
Very confident
Fairly confident
Unsure
Not very confident
I usually have to figure it out myself
7
Which of these would make the biggest difference to your peace of mind?* This field is required.
Having a clear plan
Better communication
Understanding my funding
Someone helping me navigate the system
Knowing I'm making the right decisions
Feeling like someone is keeping an eye on things
8
How much of the responsibility for managing your home care currently falls on you (or your family)?* This field is required.
Very little
Some
About half
Most of it
IAlmost all of it
9
If you could wave a magic wand, what would you most like to change?* This field is required.
I wish someone would explain things more clearly.
I wish I didn't have to chase people.
I wish I knew what to do next.
I wish someone else would help carry the responsibility.
I wish I felt more confident about the future.
10
Full Name* This field is required.
First Name
Last Name
11
Email Address* This field is required.Where would you like us to email your customised guide?
example@example.com
12
You shouldn't have to carry this on your own.Hi, Jim Moraitis here from VillageLocal. From what you've shared, it sounds like your biggest challenge is the mental load of trying to keep everything together. Keeping track of appointments - Following up phone calls - Understanding paperwork - Remembering what needs to happen next - Trying to make the right decisions. That's a lot for anyone to carry. I'd like to offer you a Home Care Clarity Call. During our conversation, we'll work together to identify what's creating the biggest mental load for you and, more importantly, what can be done to reduce it. Sometimes that means having a better conversation with your current provider. Sometimes it means preparing for an upcoming assessment. Sometimes it means putting a clearer plan in place. And occasionally, it means exploring other options. The goal to help you leave the conversation with more clarity, greater confidence and one less thing to carry.
Reserve My SpotI'll Give This A Miss
13
Appointment
14
Phone NumberPlease enter your preferred phone number for your Home Care Consultation Call
Should be Empty: