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Quotation Request
Home
I’m looking for care
Quotation Request
Send us a request for a non-binding quotation!
We have prepared the following form so we can provide you with a quotation for services, with no obligation to proceed.
Kohlberger Nursing Agency mediates care and household staff from Slovenia and Croatia, and if desired, from other EU/EEA countries. Please fill out the following request form upon which we can provide a quotation for services. Your data will be treated with discretion.
Step 1 of 5
20%
Details of required carer personnel:
Necessary German proficiency
*
No requirements
Basic level German
Advanced level German
Additional languages required? If yes, please list:
Knowledge and Skills
*
without caring experience
with caring experience
with professional qualifications
with diploma
no preference
Preferred Origin
*
any EU/EEA country
Slovenia
Croatia
other country
Country
*
Gender
*
no preference
male
female
Desired age of carer
*
Driver's license
*
no preference
yes
no
Smoker
*
no preference
non-smoker
Additional carer requirements
Details of location:
Activities (Multiple select possible)
*
24h on-call duty
Shopping
Cooking
Recreational Activities
Excursions
Escort for Doctor's Visits
Feeding Pets
Helping with Personal Hygiene
Cleaning Accommodation
Washing Clothing
Driving
Walking
Garden Work
Accommodation Size (qm)
*
Garden Size (qm)
Pets (and descriptions)
Other Activities
Is/will a nursing service be commissioned?
*
yes
no
Should the nursing service continue?
*
yes
no
Amount of persons in household
*
Please enter a number greater than or equal to
1
.
Does an additional family member require care?
*
no
yes, personal care
yes, house chores
yes, both
Do relatives live in the same accommodation?
*
yes
no
nearby
How frequently do relatives visit?
*
Night service required
*
no
occasionally
regularly
Predicted working hours per day
*
Please enter a number from
1
to
24
.
Free time per week
*
2 x 5 hours per week
1 x 10 hours per week
upon agreement
Catering
*
with familt
separate
Details of employment:
When should the employment begin?
*
Date Format: DD slash MM slash YYYY
Length of employment
*
long term
not yet defined
less than 2 months
Details of to be cared for person:
Care level
*
None
I
II
III
IV
V
VI
VII
children/youth with disabilities
adults with disabilities
Care level requested?
*
yes
no
Personal hygiene
*
with assistance
without assistance
Putting on/taking off clothing
*
with assistance
without assistance
Food intake
*
with assistance
without assitance
Getting into / out of bed
*
with assistance
without assistance
Mental state
*
clear
deranged
respective of age
unresponsive
Mobility
*
Wheelchair
walking without assistance
walking with assistance
bedridden
Toilet
*
with assistance
without assistance
urinary incontinence
faecal incontinence
catheter
Illness
Alzheimers's
Parkinson's disease
stroke
hard of hearing
multiple sclerosis
Dementia
*
no
yes, minimal
yes, middle
yes, distinctive
Other medical conditions
Penchancts (Television, Dishes, Literature... ?)
Location of nearest train station
Please provide an exact station to ensure a guarantee of reliable pickup (e.g. Graz Westbahnhof, Wien Meidling etc.)
Who will pickup the carer?
Telephone number of the above person (for further enquiry)
*
Personal details of person to be cared for:
Salutation
*
Bitte wählen
Ms.
Mr.
Name
*
First Name
Last Name
Address
*
Street and House Number
Town/City
ZIP/Postal Code
State
*
Bitte wählen
Burgenland
Kärnten (Carinthia)
Niederösterreich (Lower Austria)
Oberösterreich (Upper Austria)
Salzburg
Steiermark (Styria)
Tirol (Tyrol)
Vorarlberg
Wien (Vienna)
Telephone
*
Age
*
Height
*
Weight
*
Smoker
*
yes
no
Who should be the contractual partner?
person to be cared for
contact person / relative
Other details
Details of contact person / relative
Salutation
*
Bitte wählen
Ms.
Mr.
Name
*
First Name
Last Name
Address
*
Street and House Number
Town/City
ZIP/Postal Code
State
*
Bitte wählen
Burgenland
Kärnten (Carinthia)
Niederösterreich (Lower Austria)
Oberösterreich (Upper Austria)
Salzburg
Steiermark (Styria)
Tirol (Tyrol)
Vorarlberg
Wien (Vienna)
Telephone
*
Fax
E-Mail
