Chatting to Wellness Online (Phone Call) Chatting Sessions Registration
This form is for you (a senior) to register yourself for an Online (Phone Call) Chatting Session.
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Name *
Age *
Address *
Phone Number *
What day(s) are you available for a call? (Calls are between 6pm-9pm) *
How frequent should the calls be? *
Do you have access to a computer and/or a smart device? *
I agree to the terms and conditions of Online Chatting Sessions and for communications (Found here: *
[OPTIONAL] Additional Comments (language, hard of hearing, extension number, etc.)  
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