Support the senior housing companion program
Thank you for adding your name in support of the Senior Housing Companion Program
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First Name
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Your answer
Last Name
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Your answer
Province
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British Columbia
Alberta
Saskatchewan
Manitoba
Ontario
Quebec
Newfoundland and Labrador
New Brunswick
Nova Scotia
Prince Edward Island
Yukon
Northwest Territories
Nunavut
Other:
City
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Your answer
Email address
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Your answer
Phone number (xxx-xxx-xxxx)
*
Your answer
Do you support this national senior housing companion program?
YES, I support the proposed National Senior Housing Companion Program, which will be provided to all applicable agencies and nonprofits across Canada.
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Your answers to the following questions are extremely important to us and we would be very grateful if you would take the time to answer these for us.
Are you interested in living with a housing companion?
Yes
No
Other:
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Do you know someone who could benefit from living with a housing companion?
Yes
No
Other:
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Do you represent an Agency, Organization, or Nonprofit?
*
Yes
No
Which Agency, organization, or nonprofit do you represent? (If applicable)
Your answer
Do you operate a business or have a business concept that could support seniors living in their homes?
Your answer
Would you like to be contacted when this program is ready?
Yes
No
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