Register a beneficiary

 

 

One of our coordinators

will get in touch with you in order to do the

appropriate follow-up.

 

 

 

We look forward to responding to  your application

as quickly  as possible

depending on the availability of our volunteers.

Register a Beneficiary

Form to register new beneficiaries to the service of spiritual accompaniment of Pastoral Home Care / SASMAD
  • Choose if the person to be accompanied is male or female.
  • Date when the new registration was received or is being created (today's date)
    YYYY dash MM dash DD
  • Please indicate the territory of the Parish where the beneficiary resides (optional)
  • (Laval/ Repentigny, Centre, East, West, Anglophone)
  • Please indicate all languages that the beneficiary are able to speak
  • Specify the language for the accompaniment
  • Please indicate all that are applicable
  • Thank you so much for your registration !