Request support

Request care at home

Complete the form below and a member of our team will contact you to discuss requirements, preferences and next steps. If you need staff for an organisation, please use our staffing request form instead.

Please do not use this form for medical emergencies. In an emergency, contact the appropriate emergency service.

Your full name

Relationship to the person requiring care

For example: self, son, daughter, social worker.

Email address

Telephone number

Address or postcode

Type of care required

Preferred start date(optional)

Required days and times(optional)

For example: Monday to Friday mornings, or two visits per day.

Mobility needs

Medication support required

Communication preferences

Preferred contact time(optional)

For example: weekday afternoons.

Existing care provider(optional)

Relevant health or support information(optional)

Please share only what is needed to understand the support required. Do not include detailed medical records.

Additional information(optional)

We collect only the information needed to respond to your enquiry. Details are handled securely, are not published on this website, and are shared only with team members who need them.

I agree to Trunk Healthcare contacting me about this enquiry and I have read the privacy notice.

Your enquiry is sent over an encrypted connection and is only seen by our care team.