Benacare CSR Form

Compassionate and Affordable Care

We are a social enterprise that provides quality, compassionate and reliable Nursing and Caregiving services to: Seniors, Patients with life limiting illness, and those in need of assisted living to enable them live as independently as possible, at the comfort of their own homes.

Adopt-A-Senior

How would you like to impact?

Your name:
Your email address:
Your phone Number:
Your Age:
Area of Residence:
Would you like to meet the beneficiary physically / virtually after donation?
Would you like progress reports emailed to you?
Would you like your profile displayed on our website as a donor?
Please tick the checkboxes below for the equipments you would like to donate:

WheelchairsWalking framesCrutchesOxygen concentratorsRipple mattressHospital bedSuction machineGlucometerBlood pressure machineAdult DiapersLatex glovesCreamsFood SuppliesAll of the aboveOthers

If choosen other, please define:

Any other information?

Your name:
Your email address:
Your phone Number:
Your Age:
Area of Residence:
Relevant Qualifications:

Availability from(Start Date):

Availability ending(End Date):

Please tick the checkboxes below for the services you would like to offer:

Basic grooming (e.g. bathing)Feeding and meal preparationPressure area careMedication remindersCompanionshipSkilled Nursing CareActivities (e.g. board games, art)

Upload Identification Document:

Upload Passport picture :

Upload Qualification Certificate :

Reason for joining our volunteer program?

Your name:
Your email address:
Your phone Number:
Your Age:
Area of Residence:
Would you like to meet the beneficiary physically / virtually after donation?
Would you like progress reports emailed to you?
Would you like your profile displayed on our website as a donor?
Please pick the package you would like to donate:

Donate Skilled Nursing Care Package (24 hours): Ksh1,500

How to Donate:

1. Navigate to LIPA na MPESA.

2. SELECT PAYBILL.

3. ENTER PAYBILL NUMBER XXXX

4. ENTER ACCOUNT NUMBER: Your Name

5. ENTER AMOUNT Ksh 1,500 or More

6. CLICK SEND.

7.ENTER MPESA CONFIRMATION number below:

Enter Confirmation Number:

Donate Trained Caregiver Package (24 hours): Ksh 800

How to Donate:

1. Navigate to LIPA na MPESA.

2. SELECT PAYBILL.

3. ENTER PAYBILL NUMBER XXXX

4. ENTER ACCOUNT NUMBER: Your Name

5. ENTER AMOUNT Ksh 800 or More

6. CLICK SEND.

7.ENTER MPESA CONFIRMATION number below:

Enter Confirmation Number:

Donate Physiotherapist package (per session): Ksh 1,500

How to Donate:

1. Navigate to LIPA na MPESA.

2. SELECT PAYBILL.

3. ENTER PAYBILL NUMBER XXXX

4. ENTER ACCOUNT NUMBER: Your Name

5. ENTER AMOUNT Ksh 1,500 or More

6. CLICK SEND.

7.ENTER MPESA CONFIRMATION number below:

Enter Confirmation Number:

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