Carer Wellness Programs | The Carers Foundation Australia

REGISTER BELOW and include the date you can attend.

Name
Email
Home Phone Number
Contact Phone Number
Date of Birth (dd/mm/yyyy)
Address
Who do you care for? Please provide detail about your role
What is their Medical condition/Diagnosis?
Which Retreat are you registering for?
Date of Retreat
Are you registered with Wellways?
How did you find out about the Carers Retreat program?
Have you previously attended one of our Retreats
What was the date of the retreat you attended
On a scale of 1 to 5 (1 is low level and 5 is very high) How would you rate (please tick) your current level of stress?
I consent to participate in the Carers Foundation wellness program and the activities listed in the program. I have read information on how the Carers Foundation cares for my privacy (please see below) Please type 'I Agree'

Thank you we will be in touch with you as soon as possible to discuss