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Join the Services Bank

If you or your organization provide services for persons with intellectual challenges, we can add you to Swechha – our Services Bank, so PwC can find the services they need easily. To join Swechha, please fill out the form below. If you have any questions or would like a member of Team Amrit to contact you, please get in touch with us or call us at 011 26520998.

 

Empanelment Form

 

Your Name / Organisation's Name (Required):

 

You are a: OrganisationProfessionalParent Support GroupOther

If Organisation, name of contact person:

If Organisation, type: Government BodyPrivate BodyNGOInternational Body

If Professional, qualifications:

Specialization:

Clinical Psychology / PsychiatryDay CareOccupational Therapy
PhysiotherapySpeech Therapy / AudiologySpecial Education
CounsellingVocational TrainingSocial Work
Respite CarePaediatricsResidential Care

Other (Please Specify)

Challenges:
AutismDown SyndromeCerebral PalsyIntellectual DisabilityOther (Please Specify)

 

Contact Details:

Work Address (Required):

Pincode (Required)

Email ID (Required):

Mobile Number (Required):

Landline Number:

Website (URL):

Working Days:
MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Timings:

Referrals (if any):

Comments about your services (if any):