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Intake Form

Who needs care?
Type of care needed?
How soon do you need care?

How It Works After You Submit

Thank you for reaching out to My Care Canada. Here is what happens next after you submit your Start Care form.

Step 1 — We Review Your Request
Within 24 hours of receiving your form, a member of our care team will review your submission and reach out to you directly by phone or email to introduce ourselves and learn more about your loved one's needs.

Step 2 — Free Care Consultation
We will schedule a complimentary care consultation by phone, video or in person. This is a no-pressure conversation where we learn about your loved one, your family's situation and how My Care Canada can help.

Step 3 — Your Private Care Profile
Following your consultation, we will email you our Personalized Care Profile — a private and confidential questionnaire that helps us truly get to know your loved one before care begins. This includes their daily routine, personal preferences, favourite foods, music they love and what makes them smile.

Step 4 — Complete and Return
You can complete the Personalized Care Profile digitally or print and fill it by hand. Return it to us by email at info@mycarecanada.ca at your own pace. There is no rush — every detail you share helps us provide better care.

 

Step 5 — Care Begins
Once we receive your completed profile we match your loved one with the right caregiver and care begins. Your caregiver will already know your loved one before walking through the door for the very first time.

 

Your Privacy Matters

My Care Canada is committed to protecting your personal and health information in accordance with:

PIPEDA — Personal Information Protection and Electronic Documents Act (Federal)

PHIPA — Personal Health Information Protection Act (Ontario)

Your information is collected solely for the purpose of providing personalized home care services. It is stored securely and shared only with your assigned care team on a need-to-know basis. It will never be disclosed to any third party without your express written consent.

You have the right to access, correct or request deletion of your personal information at any time by contacting us at info@mycarecanada.ca.

In the event of a privacy breach, My Care Canada will notify you at the earliest reasonable opportunity.

By submitting this form you acknowledge and consent to the collection and use of your personal information in accordance with PIPEDA and PHIPA as described above.

Contact

MY CARE CANADA

486 Front St. West,

Terrace Level 2

Toronto, Ontario

M5V 0V2

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© 2026 by My Care Canada

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