WAHCP Membership Registration

This form is to submit your Organisation's details for membership of the Warwickshire Association of Homecare Providers Limited (WAHCP). Membership is available for free to all CQC registered Domiciliary Care providers that operate within the county of Warwickshire.

Services can be funded privately, by CCG, by Warwickshire County Council or can be voluntary.

It is not necessary to have your registered location within Warwickshire.

The association is seeking to represent the views and interests of all members, and provide simpler communications between external parties and member collective views.

Membership is entirely free for 2021-22. Organisations that apply successfully for membership at the initial phase will be classified as "Founder Members".

Membership of this association does not place member organisations under any obligations, financial or otherwise. If you have any queries, please email: contact@wahcp.co.uk

Company / Organisation Name *

Trading Name (if different from above)

CQC Registration Location Links (Optional, feel free to skip)

If you wish, please add the links to the CQC page for the registered sites you operate out of to supply services within Warwickshire

Individual Contact Name *

First

Last

Contact Phone *

Contact Email *

Company Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Would you like to be considered for referrals for: *

WAHCP is putting together some brief webpages that can signpost either potential staff or customers to members' websites. Please indicate if you wish to be included on these list(s).

Website link for prospective staff referrals *

The website link you wish prospective staff to be signposted to

Website link for prospective customer referrals *

The website link you wish prospective customers to be signposted to

Organisational Logo (optional)

Click or drag a file to this area to upload.

Intention is to include logo of members somewhere on WAHCP's webpage. Upload your logo here if you wish your organisation's logo to be included. 1 file max size 2mb

Does your organisation provide domiciliary care services directly paid for by Warwickshire County Council *

The following 3 questions regarding your level of business and time engaged with Warwickshire County Council (WCC) are entirely optional.

Current Contract Type with WCC

Years Active with WCC (optional info)

Annual revenue drawn from WCC Domiciliary Care provision (optional info)

Does your organisation provide domiciliary care services directly paid for by a Coventry & Warwickshire CCG? *

Tick those that you supply (optional)

NHS Coventry & Rugby CCG
NHS South Warwickshire CCG
NHS Warwickshire North CCG

Signature of authorised individual *