I agree to receive eldercare and related services from Charo Wongdo. I acknowledge that the information provided in this form is accurate and complete to the best of my knowledge.

I also consent to the collection, storage, and use of my personal and medical information by Charo Wongdo solely for the purpose of providing care and services. I understand that this information will be kept confidential and will not be shared with any third parties without my explicit consent, unless required by law or in emergency situations. I also acknowledge that I can update this information or withdraw my consent at any time by notifying Charo Wongdo.