Benacare Services 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.

Application Form

Your name:
Your email address:
Your phone Number:
Your Age:
Name of patient:
Age of patient:
Sex of patient
Area of Residence of patient:
Patient Diagnosis

Please Choose Service Needed

Duration:
1 Hour (Ksh 2,000)12 Hours (Ksh 3,200)24 Hours (Ksh 3,900)

Duration:
12 Hour (Ksh 2,000)24 Hours (Ksh 2,500)LIVE-IN(30 Days-Ksh 60,000)

Service & Duration:
PHYSIOTHERAPY 40 MINS – 2 HOURS(KSHS. 3,500)OCCUPATIONAL THERAPY 40 MINS – 2 HOURS (KSHS. 3,500)

Date of commencement:

Any other information?

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