Book CONNEXA CIRCLE
Guided booking:
This creates a booking reference, records key safety information, then moves to confirmation and payment step.
1. Who is making this booking?
Booking made by
I am the client
I am a family member
I am a representative / advocate
Other
Person making booking name
Relationship to client
Booker phone/email
2. Client details
Client full name
Client email / booking email
Client phone
Service
Companionship Visit
Lifestyle Assistance
Social Wellbeing Outing
Family Check-in Support
3. Visit request
Date
Time
Hours
Address / meeting point
4. Next of Kin / emergency contact
Optional if the client is booking themselves, but strongly encouraged for safety and escalation.
Next of kin name
Relationship
Next of kin phone
Next of kin email
Client consents to this person being contacted if needed, or the booker confirms they are authorised to provide this information.
5. Information staff should be aware of
Important awareness notes
Welfare flag
Green - standard visit
Amber - monitor / extra awareness needed
Red - founder review before visit
Notes
Care and medication boundary:
CONNEXA CIRCLE provides non-clinical companionship and lifestyle support. Staff do not administer medication, provide personal care, perform clinical checks, give medical advice, transport clients, handle money, or replace regulated care services.
I understand CONNEXA CIRCLE does not provide medication administration, personal care, nursing care, clinical care or emergency medical response.
I understand CONNEXA CIRCLE may escalate safeguarding, welfare or emergency concerns where risk is identified.
I consent to operational record keeping for bookings, safety, complaints, payments and service administration.
Submit Booking