NIGERIAGeopolitical Zone · State · LGA · Ward · Town

Care Request

Caregiver Nigeria Society — tell us who needs care, and we will find the right caregiver for them.

⚠ Please read first

This form is for care you are planning ahead. It is not for emergencies. If someone is in danger right now — cannot breathe, is bleeding badly, has collapsed or is unconscious — call 112 (the national emergency line, free from any network), call your state emergency number, or take them straight to the nearest hospital.

1. How many people need care?

This is the only question we need first. It decides what we ask you next.

person / people

One person needs care. We will ask about them.

2. About you

Tell us who is filling this form, so we know who to reply to.

Are you asking for care as… *

Your full name *

Your phone number *

Your email address *

3. Who needs care?

Tell us about the person who will receive the care.

Their full name *

Your relationship to them

Sex

Date of birth *

Age attained

Start typing and choose from the list — this helps us reach the right people in your community.

State *

Local Government Area *

Ward

Town or area *

Home address

Someone to call in an emergency — name

Their phone number

3. The people who need care

Fill one line for each person. We check every line as you type.

Dates must look like 09/Apr/1958. For State, LGA and Ward, start typing and pick from the list. See the guide.

S/N	Full name	Sex	Date of birth	Age	State	LGA	Ward	Town/Area	Level of need	Special notes

Add or remove a line (up to 25)

Thank you. Every line is complete and correct. We appreciate the care you have taken — it helps us send the right person to the right home.

3. Upload your list

You are registering more than 25 people, so a spreadsheet is easier. There is no limit on how many.

Do not build the file yourself. Download our ready-made template, type your people into it, and upload it back.

⬇ Download the template

Columns: S/N · Full Name · Sex · Date of Birth · State · LGA · Ward · Town / Area · Level of Need · Special Notes

Choose your completed file (.xlsx or .csv). We check it before anything is sent.

Thank you. Your file is complete and correct. We are grateful for the care you took preparing it.

4. What kind of care is needed?

Tap a heading to open it, then tick everything that is needed.

5. How much help is needed?

Choose the answer closest to a normal day. There is no shame in any answer — we ask only so we send someone with the right skills.

6. A little more about the care

Any illnesses or conditions we should know about? Any medicines they are taking? Any allergies or foods to avoid?

Please read — not everyone needs a live-in caregiver.
A Personal Care Aide is a trained, checked caregiver. They help with bathing, dressing, moving about, medicines and health — the care of a person.

A house-help (also called a Domestic Housekeeping Assistant) cleans, cooks and runs errands — the care of a home. They are not trained caregivers, and CNS does not supply them for personal care.

Many families ask for a live-in helper when what they truly need is a few hours of skilled care each day — which is often safer and costs less. If you are unsure, choose "I am not sure — please advise me" and a real person will help you decide.

How should the care be given?

When should care start?

How often?

Anything about culture, religion or language we should respect? Anything else you would like us to know?

7. Budget

We only ask for a range, not an exact figure.

Which range fits your budget? How will the care be paid for?

How did you hear about us?

Referrer ID (if a CNS trainer referred you)

8. Preview this application at a glance

Please look through everything below. If something is wrong, go back and change it.

9. Your permission

The law asks that we get your permission before we use anyone's personal details.

How would you like us to contact you?

10. Application review fee

Every request is read and assessed by a real person — never by a machine. This small fee supports that human review.

Review fee — ₦1,000 per care request

₦1,000

for 1 care request

💳 Pay now by card Secure payment by Paystack. Your review starts immediately.

Thank you for your care and patience. Taking time over these details is what allows us to send the right person to the right home.

✓ We have your request

Thank you. Your request is safely with us.

Every request is read by a real person. Our team will respond within 3 to 10 working days — and we are always working to make that faster.

You do not have to wait if you need us. Call or WhatsApp +234 703 686 9707, or email hello@caregiverng.com.

For any emergency, call 112 or go to the nearest hospital.

Caregiver Nigeria Society · CNSIP
Need help filling this form? A real person will help you.
📞 +234 703 686 9707 (call or WhatsApp) · ✉ hello@caregiverng.com
caregiverng.com · Your information is protected under the Nigeria Data Protection Act.

⚠ Please read first

1. How many people need care?

2. About you

3. Who needs care?

3. The people who need care

3. Upload your list

4. What kind of care is needed?

5. How much help is needed?

6. A little more about the care

7. Budget

8. Preview this application at a glance

9. Your permission

10. Application review fee

✓ We have your request

Save and continue later

Continue a saved application