Step 2 of 3

Tell us about your care need

We use this to recommend caregivers, packages, and helpful products. Prefer to chat? Use the AI intake instead.

Care receiver

Your name

Age

Ontario city or postal code

Care needs

Care type

What is the health or care need?

Mobility level

Medication

Optional

Current medications

Set up medication reminders in My Care. You can edit dosages and times later.

Schedule and budget

Preferred schedule / package

Budget band

Preferred caregiver type

Emergency contact

Name

Phone

Relationship

For emergencies, Pillow Care will surface this contact and the 911 CTA. We never contact this person without your action.

Family access

View only — family can see care plan and visits.Manage — family can book caregivers, edit medications, and message providers.

Documents

Optional

Uploading medical records helps Pillow Care Assistant organize summaries, reminders, and questions to ask your doctor. Documents are encrypted and only accessible to you and people you explicitly invite.

Anything else?

Notes for caregiver

Switch to chat intake

Back to role selection

Step 2 of 3

Tell us about your care need

We use this to recommend caregivers, packages, and helpful products. Prefer to chat? Use the AI intake instead.

Care receiver

Your name

Age

Ontario city or postal code

Care needs

Care type

What is the health or care need?

Mobility level

Medication

Optional

Current medications

Set up medication reminders in My Care. You can edit dosages and times later.

Schedule and budget

Preferred schedule / package

Budget band

Preferred caregiver type

Emergency contact

Name

Phone

Relationship

For emergencies, Pillow Care will surface this contact and the 911 CTA. We never contact this person without your action.

Family access

View only — family can see care plan and visits.Manage — family can book caregivers, edit medications, and message providers.

Documents

Optional

Anything else?

Notes for caregiver

Switch to chat intake