Forms

Page last updated: 08 December 2016

Aged care entry record
To formally notify the Department of Human Services that a care recipient has entered permanent residential care or commenced receiving a Home Care Package on or after 1 July 2014.

Application for approval to provide aged care
To seek approval to provide residential, community and flexible care under the Aged Care Act 1997.

Aged care Approved Provider statement
To advise the Department of Human Services that the appropriate business and security controls are in place.

Annual Prudential Compliance Statement (APCS)
The Annual Prudential Compliance Statement is a form for Approved Providers of residential aged care to demonstrate their compliance with prudential standards.

Application for an extension to the timeframe for entering into an accommodation agreement
For providers seeking an extension to the timeframe in which an accommodation agreement may be signed.

Residential aged care appointment of a nominee
For care recipients in residential care or receiving a Home Care Package who wish to authorise another person to deal with the Department of Human Services on their behalf.

Aged care home care packages transfer level of care for aged care recipients
To notify the Department of Human Services that a care recipient has transferred to a new level of Home Care Package within their service.

Financial or funding

Aged care application for the Dementia and Cognition Supplement in Home Care
To formally notify the Department of Human Services that a care recipient receiving a Home Care Package is eligible for the Dementia and Cognition Supplement.

Registration for aged care online claiming
To request access to Aged Care Online Claiming (ACOC).

Application to add or change approved care service's bank details form
To notify the Department of Human Services of the banking details for Australian Government-funded residential aged care services, home care packages and transition care services.

Aged Care Funding Instrument
The Aged Care Funding Instrument (ACFI) is the classification instrument used to pay subsidies to residential aged care providers. The relevant Department of Human Services form must be completed and signed by a person authorised by the approved provider.

Continuing care recipient Opting into the New Aged Care Arrangements – From 1 July 2014
For care recipients who are eligible to opt in to the new fees and payment arrangements from 1 July 2014, complete this Department of Human Services form.

Application for Eligible Oxygen Treatment and/or Enteral Feeding Supplement
To claim subsidy from the Department of Human Services for care recipients who require oxygen and/or enteral feeding.

Higher Accommodation Supplement forms

Application for Standard Approval for the Higher Accommodation Supplement
Application for Standard Approval for the Higher Accommodation Supplement for a significantly refurbished service.

Application for Pre-Approval for the Higher Accommodation Supplement
Application for Pre-Approval for the Higher Accommodation Supplement for a proposed refurbishment.

Confirmation of Completion for the Pre-approved Significant Refurbishment
Confirmation of completion of a pre-approved significant refurbishment.

Aged care assessors

Aged Care Client Record application form
For clients wishing to apply for Australian government-subsidised aged care and aged care service providers seeking approval for providing care in an emergency case.

Request form - ACAT access (read-only) to DHS-Medicare’s Aged Care Online Claiming website
To be completed by ACAT members when requesting access to the Department of Human Services’ (DHS) Aged Care Online Claiming (ACOC) System.

Arrangements to access aged care client record from DHS - Medicare's Aged Care Online Claiming website
In conjunction with changes to the Aged Care Online Claiming (ACOC) website, the Government requested that additional privacy and security controls be introduced.

Aged Care Education and Training Incentive Programme

Aged Care Education and Training Incentive Programme - commencement application form
For eligible aged care workers to lodge before commencement.

Aged Care Education and Training Incentive Programme - completion application form
For eligible aged care workers to lodge after completion.

Management of places forms and guidance materials for Approved Providers

Red Tape Reduction in Aged Care Places Management Guide

Guide to combining aged care services

Application to provide care

Application to vary conditions of allocation

Application for an extension of the provisional allocation period

Application for an extension of the provisional allocation period due to exceptional circumstances

Application for respite care or permanent entry to aged care homes

Notice to transfer aged care places to another provider

Report on progress towards eligibility to provide care for residential care places
This report is only in respect of provisionally allocated residential care places.