Please fill up this registration form. It only takes 10 minutes to finish the 9 pages

Data Privacy Clause

We collect personal information (e.g. name, email, mobile number) solely for the purpose of processing patient care requests requiring Nansy's caregiving services.

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Data is collected via this website form and processed lawfully, fairly, and securely in line with the Data Privacy Act of 2012 (Republic Act No. 10173).

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We retain data only as necessary, use encryption and safeguards, and share it only with third party service providers under strict confidentiality.

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You have rights to access, correct, delete or object to processing.

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Please contact us at [email protected].

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We notify breaches promptly and do not sell data.

Agree to the Terms and Conditions set forth by Nansy Care Services, Inc.

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By providing my contact details, I agree to receive messages, calls and any form of communication.

Acknowledgement of Communications

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We kindly request that incoming patients or their designated family members acting on their behalf acknowledge receipt of the following communications from Nansy Care Services.

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a. The initial email sent upon submission of your care request. Please do so in the next 12 to 24 hours.

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b. Any subsequent text messages or calls within 1-2 business days.

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Failure to acknowledge these communications will result in us pausing the processing of your care request until confirmation is received.

Care Professional Profile

Pakisagot po nang husto ang Form na ito at magbigay po ng mga dokumentong hinihingi.

Alalahanin po na ang caregiver ay kailangan may NC2 TESDA Certification, habang ang mga ibang professional types po ay kailangan ng mga PRC (Professional Regulatory Commission) licenses katulad ng nurse, midwife, physical therapist, occupational therapist, speech therapist, early childhood and development care (ECDC), SPED (special education) teacher at sign language teacher. Ang mga specialized teachers po ay dapat may LET (Licensure Exam for Teachers) credentials.

Data Privacy Clause:

Personal or sensitive personal information shall be retained only for such period as necessary to serve the purpose for which it was collected or as required under any contract or by any law, rule, or regulation.

Personal Information

Please fill-in information as completely and accurately as possible.

First Name *

Last Name *

Phone Number *

Email *

Street Address *

City *

State / Province *

Country

Zip / Postal Code *

Care Professional Information
Note: Para sa mga PDF files, wag pong lagyan ng password.

Resume *

PDF, PNG, GIF, JPEG, JPG, DOCX, DOC, XLSX, XLS or CSV ( max 10 Files )

TESDA NC2 Certification or College Diploma. Upload the file or photo *