Please either compete the appropriate form or contact our office's at: Head Office: Phone: (02) 9568 1415 Mail: PO Box 135 Petersham NSW 2049 Australia Email: esscare@zip.com.au Fax: (02) 9568 1411 For more information please complete either the Personal Form (to your right) or the Agency Inquiry Form. Please also be aware that we cannot guarantee that the information sent via this website is secure.

Personal (Family and friends) inquiry form: We would be privileged to provide you with more information on our services. Please fill in the following form our co-ordinator will contact you shortly. Please enter your name phone number email address Are these services for yourself or a family member? myself family member What services would you be most interested in? 24 Hour care Personal Care Service A Personal Care Service B Respite care Assistance Meal Preparation Household chores Overnight assistance Assessment Case management