Share your “Light Up” story

Your Name*

Email Address*

Phone Number *

For privacy purposes, before sharing your client’s story please check with them and confirm they’re happy for their story to be shared and potentially appearing in Claro Aged Care and Disability Services promotional channels.

I have obtained permission from the client named below to share this story, and they understand it may be used for internal promotion purposes.*

Client’s name*

City*

State*

How did you “Light Up” this client’s life?* (limit 300 Characters)

Please attach a picture if available (png, jpg and jpeg, up to 2MB)

Anything else we should know? (limit 300 Characters)