{"id":1189,"date":"2024-02-08T12:56:52","date_gmt":"2024-02-08T12:56:52","guid":{"rendered":"https:\/\/richsolutionsgroup.co.uk\/draft\/?page_id=1189"},"modified":"2025-03-04T08:02:36","modified_gmt":"2025-03-04T08:02:36","slug":"request-care","status":"publish","type":"page","link":"https:\/\/richsolutionsgroup.co.uk\/draft\/request-care\/","title":{"rendered":"Request Care"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;gcid-7e2eaaff-a4e7-442c-83d7-594dc7701757&#8243; custom_padding=&#8221;0px||0px||true|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{%22gcid-7e2eaaff-a4e7-442c-83d7-594dc7701757%22:%91%22background_color%22%93}&#8221;][et_pb_row use_custom_gutter=&#8221;on&#8221; gutter_width=&#8221;1&#8243; make_equal=&#8221;on&#8221; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; width=&#8221;100%&#8221; max_width=&#8221;1600px&#8221; custom_padding=&#8221;3%|5%|3%|5%|true|true&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.4&#8243; text_font=&#8221;||||||||&#8221; header_font=&#8221;||||||||&#8221; header_2_font=&#8221;||||||||&#8221; header_2_font_size=&#8221;40px&#8221; header_2_letter_spacing=&#8221;1px&#8221; header_2_line_height=&#8221;1.4em&#8221; header_3_font=&#8221;|700||on|||||&#8221; header_3_text_color=&#8221;gcid-f09aec98-6538-4916-9416-34403fa780af&#8221; header_3_font_size=&#8221;14px&#8221; header_3_letter_spacing=&#8221;1px&#8221; header_3_line_height=&#8221;2em&#8221; background_layout=&#8221;dark&#8221; max_width=&#8221;550px&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;||||false|false&#8221; header_font_tablet=&#8221;||||||||&#8221; header_font_phone=&#8221;||||||||&#8221; header_font_last_edited=&#8221;on|desktop&#8221; header_font_size_tablet=&#8221;3.5vw&#8221; header_font_size_phone=&#8221;4.8vw&#8221; header_font_size_last_edited=&#8221;on|phone&#8221; header_2_font_size_tablet=&#8221;3vw&#8221; header_2_font_size_phone=&#8221;5vw&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{%22gcid-f09aec98-6538-4916-9416-34403fa780af%22:%91%22header_3_text_color%22,%22header_3_text_color%22,%22header_3_text_color%22,%22header_3_text_color%22%93}&#8221;]<\/p>\n<h1>Request Care<\/h1>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; make_equal=&#8221;on&#8221; use_custom_gutter=&#8221;on&#8221; gutter_width=&#8221;1&#8243; specialty=&#8221;on&#8221; custom_padding_last_edited=&#8221;on|phone&#8221; bg_img_1=&#8221;https:\/\/richsolutionsgroup.co.uk\/draft\/wp-content\/uploads\/2024\/02\/1.png&#8221; disabled_on=&#8221;off|off|off&#8221; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; inner_width=&#8221;100%&#8221; inner_max_width=&#8221;100%&#8221; custom_padding=&#8221;20px||||false|false&#8221; custom_padding_tablet=&#8221;20px||||false|false&#8221; custom_padding_phone=&#8221;20px||||false|false&#8221; background_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_divider show_divider=&#8221;off&#8221; disabled_on=&#8221;off|off|on&#8221; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; background_image=&#8221;https:\/\/richsolutionsgroup.co.uk\/draft\/wp-content\/uploads\/2023\/06\/support2.jpg&#8221; custom_margin=&#8221;0px||-14px||false|false&#8221; custom_padding=&#8221;34.7%||34.7%||true|false&#8221; custom_padding_tablet=&#8221;20%||20%||true|false&#8221; custom_padding_phone=&#8221;100%||0%||false|false&#8221; custom_padding_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_divider][\/et_pb_column][et_pb_column type=&#8221;2_3&#8243; specialty_columns=&#8221;2&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_row_inner make_equal=&#8221;on&#8221; custom_padding_last_edited=&#8221;on|phone&#8221; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; width=&#8221;100%&#8221; max_width=&#8221;100%&#8221; custom_padding=&#8221;0px|2%|0px|2%|false|true&#8221; custom_padding_tablet=&#8221;3%||||false|true&#8221; custom_padding_phone=&#8221;8.1%|2%|0px|2%|false|true&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column_inner saved_specialty_column_type=&#8221;2_3&#8243; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;gcid-2c382193-0415-4b06-8584-19ec88ce01e7&#8243; custom_padding=&#8221;2%|2%|2%|2%|true|true&#8221; border_radii=&#8221;on|7px|7px|7px|7px&#8221; border_width_bottom=&#8221;4px&#8221; border_color_bottom=&#8221;gcid-f09aec98-6538-4916-9416-34403fa780af&#8221; global_colors_info=&#8221;{%22gcid-f09aec98-6538-4916-9416-34403fa780af%22:%91%22border_color_bottom%22%93,%22gcid-2c382193-0415-4b06-8584-19ec88ce01e7%22:%91%22background_color%22%93}&#8221;][et_pb_text _builder_version=&#8221;4.24.0&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;16px&#8221; header_2_font=&#8221;||||||||&#8221; header_2_text_color=&#8221;#FFFFFF&#8221; header_2_font_size=&#8221;24px&#8221; header_2_line_height=&#8221;1.5em&#8221; header_2_font_size_tablet=&#8221;2.4vw&#8221; header_2_font_size_phone=&#8221;3.8vw&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2>Supported Living Services Request Form<\/h2>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.24.0&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|300|||||||&#8221; text_text_color=&#8221;#FFFFFF&#8221; text_font_size=&#8221;16px&#8221; text_line_height=&#8221;1.4em&#8221; positioning=&#8221;relative&#8221; custom_margin=&#8221;||18px|||&#8221; text_font_size_tablet=&#8221;2vw&#8221; text_font_size_phone=&#8221;3.4vw&#8221; text_font_size_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>We are glad that you have selected us as your care provider. Our mission is to provide you with the highest quality of service and care. To do this, we need to learn more about you and your situation.<\/p>\n<p>Please complete the form below with some information about yourself and your needs. This will help us to assign you the best caregiver for your case and to give you customised advice and support. We value your cooperation, and we hope to hear from you soon.<\/p>\n<p>[\/et_pb_text][\/et_pb_column_inner][\/et_pb_row_inner][et_pb_row_inner use_custom_gutter=&#8221;on&#8221; gutter_width=&#8221;2&#8243; make_equal=&#8221;on&#8221; _builder_version=&#8221;4.21.0&#8243; _module_preset=&#8221;default&#8221; width=&#8221;100%&#8221; max_width=&#8221;100%&#8221; custom_padding=&#8221;|3%||3%|false|true&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column_inner saved_specialty_column_type=&#8221;2_3&#8243; _builder_version=&#8221;4.20.2&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#FFFFFF&#8221; custom_padding=&#8221;2%|2%|2%|2%|true|true&#8221; border_radii=&#8221;on|7px|7px|7px|7px&#8221; border_width_bottom=&#8221;4px&#8221; border_color_bottom=&#8221;gcid-f09aec98-6538-4916-9416-34403fa780af&#8221; box_shadow_style=&#8221;preset1&#8243; global_colors_info=&#8221;{%22gcid-f09aec98-6538-4916-9416-34403fa780af%22:%91%22border_color_bottom%22%93}&#8221;][et_pb_text _builder_version=&#8221;4.24.0&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|300|||||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;16px&#8221; text_line_height=&#8221;1.4em&#8221; positioning=&#8221;relative&#8221; custom_margin=&#8221;||18px|||&#8221; text_font_size_tablet=&#8221;2vw&#8221; text_font_size_phone=&#8221;3.4vw&#8221; text_font_size_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"forminator-ui forminator-custom-form forminator-custom-form-1192 forminator-design--default  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-1192\" data-uid=\"6a1d1833b2d49\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-1192\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-1192 forminator-design--default  forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"1192\"\n\t\t\t\t data-color-option=\"default\" data-design=\"default\" data-grid=\"open\" style=\"display: none;\"\n\t\t\t\tdata-uid=\"6a1d1833b2d49\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-row forminator-no-margin\" data-multiple=\"true\"><div class=\"forminator-col forminator-col-md-6\"><div class=\"forminator-field\"><label for=\"forminator-field-first-name-1_6a1d1833b2d49\" id=\"forminator-field-first-name-1_6a1d1833b2d49-label\" class=\"forminator-label\">First Name<\/label><input type=\"text\" name=\"name-1-first-name\" placeholder=\"\" id=\"forminator-field-first-name-1_6a1d1833b2d49\" class=\"forminator-input\" aria-required=\"false\" data-multi=\"1\" autocomplete=\"given-name\" value=\"\" \/><\/div><\/div><div class=\"forminator-col forminator-col-md-6\"><div class=\"forminator-field\"><label for=\"forminator-field-last-name-1_6a1d1833b2d49\" id=\"forminator-field-last-name-1_6a1d1833b2d49-label\" class=\"forminator-label\">Last Name<\/label><input type=\"text\" name=\"name-1-last-name\" placeholder=\"\" id=\"forminator-field-last-name-1_6a1d1833b2d49\" class=\"forminator-input\" aria-required=\"false\" data-multi=\"1\" autocomplete=\"family-name\" value=\"\" \/><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_6a1d1833b2d49\" id=\"forminator-field-email-1_6a1d1833b2d49-label\" class=\"forminator-label\">Email Address <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"\" id=\"forminator-field-email-1_6a1d1833b2d49\" class=\"forminator-input forminator-email--field\" data-required=\"1\" aria-required=\"true\" autocomplete=\"email\" \/><\/div><\/div><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_6a1d1833b2d49\" id=\"forminator-field-phone-1_6a1d1833b2d49-label\" class=\"forminator-label\">Contact Phone <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-1_6a1d1833b2d49\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" data-national_mode=\"disabled\" data-country=\"gb\" data-validation=\"international\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-1\" class=\"forminator-field-date forminator-col forminator-col-12 \"><label for=\"forminator-field-date-1\" id=\"forminator-field-date-1-label\" class=\"forminator-label\">Date of Birth <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-date-select\"><div class=\"forminator-row\" data-multiple=\"true\"><div id=\"date-1-day\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-1192__field--date-1-day_6a1d1833b2d49\" id=\"forminator-field-1192__field--date-1-day_6a1d1833b2d49-label\" class=\"forminator-label\">Day<\/label><select name=\"date-1-day\" id=\"forminator-field-1192__field--date-1-day_6a1d1833b2d49\" class=\"forminator-select2\" data-format=\"dd\/mm\/yy\" data-parent=\"date-1\" aria-labelledby=\"forminator-field-1192__field--date-1-day_6a1d1833b2d49-label\" data-default-value=\"\"><option value=\"\" selected=\"selected\">Select day<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><option value=\"13\" >13<\/option><option value=\"14\" >14<\/option><option value=\"15\" >15<\/option><option value=\"16\" >16<\/option><option value=\"17\" >17<\/option><option value=\"18\" >18<\/option><option value=\"19\" >19<\/option><option value=\"20\" >20<\/option><option value=\"21\" >21<\/option><option value=\"22\" >22<\/option><option value=\"23\" >23<\/option><option value=\"24\" >24<\/option><option value=\"25\" >25<\/option><option value=\"26\" >26<\/option><option value=\"27\" >27<\/option><option value=\"28\" >28<\/option><option value=\"29\" >29<\/option><option value=\"30\" >30<\/option><option value=\"31\" >31<\/option><\/select><\/div><\/div><div id=\"date-1-month\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-1192__field--date-1-month_6a1d1833b2d49\" id=\"forminator-field-1192__field--date-1-month_6a1d1833b2d49-label\" class=\"forminator-label\">Month<\/label><select name=\"date-1-month\" id=\"forminator-field-1192__field--date-1-month_6a1d1833b2d49\" class=\"forminator-select2\" data-format=\"dd\/mm\/yy\" data-parent=\"date-1\" aria-labelledby=\"forminator-field-1192__field--date-1-month_6a1d1833b2d49-label\" data-default-value=\"\"><option value=\"\" selected=\"selected\">Select month<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><\/select><\/div><\/div><div id=\"date-1-year\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-1192__field--date-1-year_6a1d1833b2d49\" id=\"forminator-field-1192__field--date-1-year_6a1d1833b2d49-label\" class=\"forminator-label\">Year<\/label><select name=\"date-1-year\" id=\"forminator-field-1192__field--date-1-year_6a1d1833b2d49\" class=\"forminator-select2\" data-format=\"dd\/mm\/yy\" data-parent=\"date-1\" aria-labelledby=\"forminator-field-1192__field--date-1-year_6a1d1833b2d49-label\" data-default-value=\"2026\"><option value=\"\" >Select Year<\/option><option value=\"2126\" >2126<\/option><option value=\"2125\" >2125<\/option><option value=\"2124\" >2124<\/option><option value=\"2123\" >2123<\/option><option value=\"2122\" >2122<\/option><option value=\"2121\" >2121<\/option><option value=\"2120\" >2120<\/option><option value=\"2119\" >2119<\/option><option value=\"2118\" >2118<\/option><option value=\"2117\" >2117<\/option><option value=\"2116\" >2116<\/option><option value=\"2115\" >2115<\/option><option value=\"2114\" >2114<\/option><option value=\"2113\" >2113<\/option><option value=\"2112\" >2112<\/option><option value=\"2111\" >2111<\/option><option value=\"2110\" >2110<\/option><option value=\"2109\" >2109<\/option><option value=\"2108\" >2108<\/option><option value=\"2107\" >2107<\/option><option value=\"2106\" >2106<\/option><option value=\"2105\" >2105<\/option><option value=\"2104\" >2104<\/option><option value=\"2103\" >2103<\/option><option value=\"2102\" >2102<\/option><option value=\"2101\" >2101<\/option><option value=\"2100\" >2100<\/option><option value=\"2099\" >2099<\/option><option value=\"2098\" >2098<\/option><option value=\"2097\" >2097<\/option><option value=\"2096\" >2096<\/option><option value=\"2095\" >2095<\/option><option value=\"2094\" >2094<\/option><option value=\"2093\" >2093<\/option><option value=\"2092\" >2092<\/option><option value=\"2091\" >2091<\/option><option value=\"2090\" >2090<\/option><option value=\"2089\" >2089<\/option><option value=\"2088\" >2088<\/option><option value=\"2087\" >2087<\/option><option value=\"2086\" >2086<\/option><option value=\"2085\" >2085<\/option><option value=\"2084\" >2084<\/option><option value=\"2083\" >2083<\/option><option value=\"2082\" >2082<\/option><option value=\"2081\" >2081<\/option><option value=\"2080\" >2080<\/option><option value=\"2079\" >2079<\/option><option value=\"2078\" >2078<\/option><option value=\"2077\" >2077<\/option><option value=\"2076\" >2076<\/option><option value=\"2075\" >2075<\/option><option value=\"2074\" >2074<\/option><option value=\"2073\" >2073<\/option><option value=\"2072\" >2072<\/option><option value=\"2071\" >2071<\/option><option value=\"2070\" >2070<\/option><option value=\"2069\" >2069<\/option><option value=\"2068\" >2068<\/option><option value=\"2067\" >2067<\/option><option value=\"2066\" >2066<\/option><option value=\"2065\" >2065<\/option><option value=\"2064\" >2064<\/option><option value=\"2063\" >2063<\/option><option value=\"2062\" >2062<\/option><option value=\"2061\" >2061<\/option><option value=\"2060\" >2060<\/option><option value=\"2059\" >2059<\/option><option value=\"2058\" >2058<\/option><option value=\"2057\" >2057<\/option><option value=\"2056\" >2056<\/option><option value=\"2055\" >2055<\/option><option value=\"2054\" >2054<\/option><option value=\"2053\" >2053<\/option><option value=\"2052\" >2052<\/option><option value=\"2051\" >2051<\/option><option value=\"2050\" >2050<\/option><option value=\"2049\" >2049<\/option><option value=\"2048\" >2048<\/option><option value=\"2047\" >2047<\/option><option value=\"2046\" >2046<\/option><option value=\"2045\" >2045<\/option><option value=\"2044\" >2044<\/option><option value=\"2043\" >2043<\/option><option value=\"2042\" >2042<\/option><option value=\"2041\" >2041<\/option><option value=\"2040\" >2040<\/option><option value=\"2039\" >2039<\/option><option value=\"2038\" >2038<\/option><option value=\"2037\" >2037<\/option><option value=\"2036\" >2036<\/option><option value=\"2035\" >2035<\/option><option value=\"2034\" >2034<\/option><option value=\"2033\" >2033<\/option><option value=\"2032\" >2032<\/option><option value=\"2031\" >2031<\/option><option value=\"2030\" >2030<\/option><option value=\"2029\" >2029<\/option><option value=\"2028\" >2028<\/option><option value=\"2027\" >2027<\/option><option value=\"2026\" selected=\"selected\">2026<\/option><option value=\"2025\" >2025<\/option><option value=\"2024\" >2024<\/option><option value=\"2023\" >2023<\/option><option value=\"2022\" >2022<\/option><option value=\"2021\" >2021<\/option><option value=\"2020\" >2020<\/option><option value=\"2019\" >2019<\/option><option value=\"2018\" >2018<\/option><option value=\"2017\" >2017<\/option><option value=\"2016\" >2016<\/option><option value=\"2015\" >2015<\/option><option value=\"2014\" >2014<\/option><option value=\"2013\" >2013<\/option><option value=\"2012\" >2012<\/option><option value=\"2011\" >2011<\/option><option value=\"2010\" >2010<\/option><option value=\"2009\" >2009<\/option><option value=\"2008\" >2008<\/option><option value=\"2007\" >2007<\/option><option value=\"2006\" >2006<\/option><option value=\"2005\" >2005<\/option><option value=\"2004\" >2004<\/option><option value=\"2003\" >2003<\/option><option value=\"2002\" >2002<\/option><option value=\"2001\" >2001<\/option><option value=\"2000\" >2000<\/option><option value=\"1999\" >1999<\/option><option value=\"1998\" >1998<\/option><option value=\"1997\" >1997<\/option><option value=\"1996\" >1996<\/option><option value=\"1995\" >1995<\/option><option value=\"1994\" >1994<\/option><option value=\"1993\" >1993<\/option><option value=\"1992\" >1992<\/option><option value=\"1991\" >1991<\/option><option value=\"1990\" >1990<\/option><option value=\"1989\" >1989<\/option><option value=\"1988\" >1988<\/option><option value=\"1987\" >1987<\/option><option value=\"1986\" >1986<\/option><option value=\"1985\" >1985<\/option><option value=\"1984\" >1984<\/option><option value=\"1983\" >1983<\/option><option value=\"1982\" >1982<\/option><option value=\"1981\" >1981<\/option><option value=\"1980\" >1980<\/option><option value=\"1979\" >1979<\/option><option value=\"1978\" >1978<\/option><option value=\"1977\" >1977<\/option><option value=\"1976\" >1976<\/option><option value=\"1975\" >1975<\/option><option value=\"1974\" >1974<\/option><option value=\"1973\" >1973<\/option><option value=\"1972\" >1972<\/option><option value=\"1971\" >1971<\/option><option value=\"1970\" >1970<\/option><option value=\"1969\" >1969<\/option><option value=\"1968\" >1968<\/option><option value=\"1967\" >1967<\/option><option value=\"1966\" >1966<\/option><option value=\"1965\" >1965<\/option><option value=\"1964\" >1964<\/option><option value=\"1963\" >1963<\/option><option value=\"1962\" >1962<\/option><option value=\"1961\" >1961<\/option><option value=\"1960\" >1960<\/option><option value=\"1959\" >1959<\/option><option value=\"1958\" >1958<\/option><option value=\"1957\" >1957<\/option><option value=\"1956\" >1956<\/option><option value=\"1955\" >1955<\/option><option value=\"1954\" >1954<\/option><option value=\"1953\" >1953<\/option><option value=\"1952\" >1952<\/option><option value=\"1951\" >1951<\/option><option value=\"1950\" >1950<\/option><option value=\"1949\" >1949<\/option><option value=\"1948\" >1948<\/option><option value=\"1947\" >1947<\/option><option value=\"1946\" >1946<\/option><option value=\"1945\" >1945<\/option><option value=\"1944\" >1944<\/option><option value=\"1943\" >1943<\/option><option value=\"1942\" >1942<\/option><option value=\"1941\" >1941<\/option><option value=\"1940\" >1940<\/option><option value=\"1939\" >1939<\/option><option value=\"1938\" >1938<\/option><option value=\"1937\" >1937<\/option><option value=\"1936\" >1936<\/option><option value=\"1935\" >1935<\/option><option value=\"1934\" >1934<\/option><option value=\"1933\" >1933<\/option><option value=\"1932\" >1932<\/option><option value=\"1931\" >1931<\/option><option value=\"1930\" >1930<\/option><option value=\"1929\" >1929<\/option><option value=\"1928\" >1928<\/option><option value=\"1927\" >1927<\/option><option value=\"1926\" >1926<\/option><\/select><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-1\" class=\"forminator-field-checkbox forminator-col forminator-col-12 \"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-1-6a1d1833b2d49-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-1-6a1d1833b2d49-label\" class=\"forminator-label\">Type of Care Needed<\/span><label id=\"forminator-field-checkbox-1-1-6a1d1833b2d49-label\" for=\"forminator-field-checkbox-1-1-6a1d1833b2d49\" class=\"forminator-checkbox\" title=\"Personal Care\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Personal-care\" id=\"forminator-field-checkbox-1-1-6a1d1833b2d49\" aria-labelledby=\"forminator-field-checkbox-1-1-6a1d1833b2d49-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Personal Care<\/span><\/label><label id=\"forminator-field-checkbox-1-2-6a1d1833b2d49-label\" for=\"forminator-field-checkbox-1-2-6a1d1833b2d49\" class=\"forminator-checkbox\" title=\"Medication Management\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Medication-management\" id=\"forminator-field-checkbox-1-2-6a1d1833b2d49\" aria-labelledby=\"forminator-field-checkbox-1-2-6a1d1833b2d49-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Medication Management<\/span><\/label><label id=\"forminator-field-checkbox-1-3-6a1d1833b2d49-label\" for=\"forminator-field-checkbox-1-3-6a1d1833b2d49\" class=\"forminator-checkbox\" title=\"Household Chores\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Household-chores\" id=\"forminator-field-checkbox-1-3-6a1d1833b2d49\" aria-labelledby=\"forminator-field-checkbox-1-3-6a1d1833b2d49-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Household Chores<\/span><\/label><label id=\"forminator-field-checkbox-1-4-6a1d1833b2d49-label\" for=\"forminator-field-checkbox-1-4-6a1d1833b2d49\" class=\"forminator-checkbox\" title=\"Respite Care\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Respite-Care\" id=\"forminator-field-checkbox-1-4-6a1d1833b2d49\" aria-labelledby=\"forminator-field-checkbox-1-4-6a1d1833b2d49-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Respite Care<\/span><\/label><label id=\"forminator-field-checkbox-1-5-6a1d1833b2d49-label\" for=\"forminator-field-checkbox-1-5-6a1d1833b2d49\" class=\"forminator-checkbox\" title=\"Errands and Shopping\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Errands-and-Shopping\" id=\"forminator-field-checkbox-1-5-6a1d1833b2d49\" aria-labelledby=\"forminator-field-checkbox-1-5-6a1d1833b2d49-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Errands and Shopping<\/span><\/label><label id=\"forminator-field-checkbox-1-6-6a1d1833b2d49-label\" for=\"forminator-field-checkbox-1-6-6a1d1833b2d49\" class=\"forminator-checkbox\" title=\"Companionship\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Companionship\" id=\"forminator-field-checkbox-1-6-6a1d1833b2d49\" aria-labelledby=\"forminator-field-checkbox-1-6-6a1d1833b2d49-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Companionship<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-1\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-1_6a1d1833b2d49\" id=\"forminator-field-textarea-1_6a1d1833b2d49-label\" class=\"forminator-label\">Additional Details or Special Requests<\/label><textarea name=\"textarea-1\" placeholder=\"\" id=\"forminator-field-textarea-1_6a1d1833b2d49\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"captcha-1\" class=\"forminator-field-captcha forminator-col forminator-col-12 \"><div class=\"forminator-captcha-left forminator-g-recaptcha recaptcha-invisible\" data-theme=\"light\" data-badge=\"bottomright\" data-sitekey=\"6Lfke1gnAAAAAMkjCgofGZ6lW4r306mEOTjxODNb\" data-size=\"invisible\"><\/div> <\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\">Apply Now<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"d6e7bfb374\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/draft\/wp-json\/wp\/v2\/pages\/1189\" \/><input type=\"hidden\" name=\"form_id\" value=\"1192\"><input type=\"hidden\" name=\"page_id\" value=\"1189\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/richsolutionsgroup.co.uk\/draft\/request-care\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form>\n<p>[\/et_pb_text][\/et_pb_column_inner][\/et_pb_row_inner][\/et_pb_column][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Request CareSupported Living Services Request FormWe are glad that you have selected us as your care provider. Our mission is to provide you with the highest quality of service and care. To do this, we need to learn more about you and your situation. Please complete the form below with some information about yourself and [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-1189","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/richsolutionsgroup.co.uk\/draft\/wp-json\/wp\/v2\/pages\/1189","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/richsolutionsgroup.co.uk\/draft\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/richsolutionsgroup.co.uk\/draft\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/richsolutionsgroup.co.uk\/draft\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/richsolutionsgroup.co.uk\/draft\/wp-json\/wp\/v2\/comments?post=1189"}],"version-history":[{"count":19,"href":"https:\/\/richsolutionsgroup.co.uk\/draft\/wp-json\/wp\/v2\/pages\/1189\/revisions"}],"predecessor-version":[{"id":1589,"href":"https:\/\/richsolutionsgroup.co.uk\/draft\/wp-json\/wp\/v2\/pages\/1189\/revisions\/1589"}],"wp:attachment":[{"href":"https:\/\/richsolutionsgroup.co.uk\/draft\/wp-json\/wp\/v2\/media?parent=1189"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}