Legal & compliance

FAST PSW — private PSW and home care in Ontario. Plain-language policies and forms.

Client Intake Form

Version 1.0 · Last updated 2026-06-10

Important: These documents are provided as templates for FAST PSW. They are not legal advice. Have a qualified Ontario lawyer or privacy professional review them before launch.

Please complete all sections of the intake form. This helps us provide safe, appropriate home care. Fields marked required must be completed before booking.

If the client cannot sign, a substitute decision-maker may sign on their behalf where permitted by law.

Electronic signature

Type your full name as your electronic signature. Required before booking care.

I have read and agree to this document (version 1.0).

Client full name * Date * Electronic signature (type full name) *

Substitute decision-maker / guardian (if client cannot sign)

A substitute decision-maker is signing on behalf of the client.

Guardian / SDM name Relationship to client Guardian electronic signature

Intake information

Date of birth Emergency contact name Emergency contact phone Mobility needs Allergies Medications (optional) Care needs & goals Home access instructions