Benacare CSR Form

Compassionate and Affordable Care

We are a social enterprise that provides quality, compassionate and reliable Nursing and Caregiving services to: Seniors, Patients with life limiting illness, and those in need of assisted living to enable them live as independently as possible, at the comfort of their own homes.

Adopt-A-Senior

    How would you like to impact?

    Your name:
    Your email address:
    Your phone Number:
    Your Age:
    Area of Residence:
    Would you like to meet the beneficiary physically / virtually after donation?
    Would you like progress reports emailed to you?
    Would you like your profile displayed on our website as a donor?
    Please tick the checkboxes below for the equipments you would like to donate:

    WheelchairsWalking framesCrutchesOxygen concentratorsRipple mattressHospital bedSuction machineGlucometerBlood pressure machineAdult DiapersLatex glovesCreamsFood SuppliesAll of the aboveOthers

    If choosen other, please define:

    Any other information?

    Your name:
    Your email address:
    Your phone Number:
    Your Age:
    Area of Residence:
    Relevant Qualifications:

    Availability from(Start Date):

    Availability ending(End Date):

    Please tick the checkboxes below for the services you would like to offer:

    Basic grooming (e.g. bathing)Feeding and meal preparationPressure area careMedication remindersCompanionshipSkilled Nursing CareActivities (e.g. board games, art)

    Upload Identification Document:

    Upload Passport picture :

    Upload Qualification Certificate :

    Reason for joining our volunteer program?

    Your name:
    Your email address:
    Your phone Number:
    Your Age:
    Area of Residence:
    Would you like to meet the beneficiary physically / virtually after donation?
    Would you like progress reports emailed to you?
    Would you like your profile displayed on our website as a donor?
    Please pick the package you would like to donate:

    Donate Skilled Nursing Care Package (24 hours): Ksh1,500

    How to Donate:

    1. Navigate to LIPA na MPESA.

    2. SELECT PAYBILL.

    3. ENTER PAYBILL NUMBER XXXX

    4. ENTER ACCOUNT NUMBER: Your Name

    5. ENTER AMOUNT Ksh 1,500 or More

    6. CLICK SEND.

    7.ENTER MPESA CONFIRMATION number below:

    Enter Confirmation Number:

    Donate Trained Caregiver Package (24 hours): Ksh 800

    How to Donate:

    1. Navigate to LIPA na MPESA.

    2. SELECT PAYBILL.

    3. ENTER PAYBILL NUMBER XXXX

    4. ENTER ACCOUNT NUMBER: Your Name

    5. ENTER AMOUNT Ksh 800 or More

    6. CLICK SEND.

    7.ENTER MPESA CONFIRMATION number below:

    Enter Confirmation Number:

    Donate Physiotherapist package (per session): Ksh 1,500

    How to Donate:

    1. Navigate to LIPA na MPESA.

    2. SELECT PAYBILL.

    3. ENTER PAYBILL NUMBER XXXX

    4. ENTER ACCOUNT NUMBER: Your Name

    5. ENTER AMOUNT Ksh 1,500 or More

    6. CLICK SEND.

    7.ENTER MPESA CONFIRMATION number below:

    Enter Confirmation Number:

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