Request a service

Important: The form has only successfully submitted when you see a message in green stating: "Thank you for submitting your form. A member of the team will be in touch"

If you are having any problems with the form, please email info@roarforlife.org

Are you requesting on behalf of someone?

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DETAILS OF THE PERSON FILLING OUT THIS FORM

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Whom the service is for:

PERSONAL & CONTACT INFORMATION

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Does this person live alone?

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Emergency contact 1

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Emergency contact 2

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Choose your services

We have a range of opportunities to help people Stay Mobile and Stay Connected in later life. Select the ones you’re interested in and we will be in touch to discuss the best option for you.

Due to current Government restrictions we are operating a limited service, for more contact us.

Digital Participation

Available Monday—Friday

Befriending/Telephone Befriending

Aimed at people 85* and over, Available Monday—Friday (*We can often make allowances for those under 85 who have no support)

Stay Mobile Stay Connected (Frailty Prevention)

Available Monday - Friday

Health & Wellbeing Clubs & Projects

Available Monday—Friday in venues throughout Renfrewshire

Otago Classes (Strength & Balance exercises)

Available Monday—Friday in venues throughout Renfrewshire

Other comments & requests

Where did you hear about us?

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