Website Form
Here the provider can enter all information needed to build and maintain their customized website.
Personal/Business Information - Step 1 of 2
Enter the name of your home.
Enter First and Last name.
Give a short bio about yourself. (ie. what you have achieved, where you are originally from, your interests etc.)
Click or drag a file to this area to upload.
Add a Portrait photo of the Provider for the front page on the top.
Click or drag a file to this area to upload.
Add a Background photo for the top section of the website.
Describe the feel of the home and its surrounding area. (No stats)
Select how many bedrooms are available in your home.
Select how many bathrooms are available in your home.
Select how many residents are currently in your home.
Select how many Caregivers are currently in your home.
Selected Value: 1000
Select the square feet of your home.
Selected Value: 1940
Select the year your home was built.
Does your home have any walk paths?
Does your home have a patio?
Add the address for your home.
Enter the main phone number for your home.
Enter contact email for your home.
Do you have a personal Social Media you would like to use for your website?