Caring financial Advice

 

Affinity Financial Awareness - Care Division

FREEPHONE 0800 0197 714

Please complete the form below to obtain a FREE initial consultation to discuss a suitable way forward through the long term care maze, offering financial solutions designed entirely with your circumstances in mind. Your privacy is important to us, and information provided will never be released to third parties without your permission.

(If it is more convenient then please download our form here for printing at home and sending via our FREEPOST address. You will need a copy of Adobe Acrobat Reader, downloadable from here at no cost.)

Your Details
Title	Mr Mrs Ms Miss Dr Other
First Name
Last Name
Address
Post Code
Telephone
Email
Best Time to Call	Morning Afternoon Evening No Preference
Comments/Questions
Details of Person needing Care (If Different)
Relationship to You?
Title	Mr Mrs Ms Miss Dr Other
First Name
Last Name
Financial Information
Weekly Income	(approx)
Income from all sources	£
Capital and Savings	(approx)
Property	£
Investments and Deposits	£
Care Fees Information
Weekly Costs	(approx)
Residential / Nursing Home	£
Domiciliary Care	£
Is an Enduring Power of Attorney held?	unsure yes no