New Client Information Form

Important: The form below is about the client receiving care.

If you are completing this on behalf of someone else, please ensure all details entered below relate to the client, not your own personal information.

About Ellia and We Work

Ellia provides friendly, practical home help for older adults across Gloucestershire and the Cotswolds. In this video, we explain how Ellia works, what support looks like day to day, and how we match you with a trusted Home Helper. We can help with everyday, non-medical support such as: Companionship and social visits Shopping and errands Light housekeeping and meal support Transport to appointments Help staying organised at home If you’re looking for reliable home support for an older parent, or you’d like a bit of help yourself, Ellia makes it simple to get started. Based in Gloucestershire and supporting families in and around Stroud, Cheltenham, Cirencester, Tetbury, Gloucester and nearby towns and villages. Find out more: ellia.org.uk Call: +44 (0) 1452 447 109 Email: hello@ellia.org.uk

Need help? Contact hello@ellia.org.uk or call +44 (0) 1452 447 109

Thank you

Thank you for choosing Ellia. This form helps us understand your needs so we can set up help accurately and provide the best possible support from the start