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Full name of the care-dependent person Required Date of birth Required Format: DD/MM/YYYY Home address (street, ZIP, city) Required Health insurer / Pflegekasse name Required E.g. AOK, Barmer, Techniker Krankenkasse, DAK. The Pflegekasse is part of your health insurer. Health-insurance number Required Printed on your Gesundheitskarte. Starts with a letter. 🔒 Stored encrypted; only used to generate your draft. Your own estimate of the care level Required If known — otherwise select 'unknown', we'll help with the categorisation. Care situation Required What restrictions exist in everyday life? Required Bullet points are fine — e.g. mobility, dementia, help dressing, fall risk, incontinence. Buronia will later structure this along the NBA modules. Phone number for the Pflegekasse to call back Required

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Private Buronia help — not a government service. Pflegekasse (bei Ihrer Krankenkasse) ↗

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