Application to provide care This form replaces the previous four application Application for a determination that an approved provider is in a position to provide care Residential Care – Application for a determination that an approved provider is in a position to provide care Home Care – Application for a determination that an approved provider is in a position to provide care Flexible Care – Application for a determination that an approved provider is in a position to provide care Transition Care – This application may be submitted at any time before the end of the provisional allocation period. A decision to make a determination or reject your application will be made within 28 days after the Department receives your application. The Department will notify you of the outcome of your application. This form has three parts: Part A: All applicants to complete. Applicants for Residential Care to complete. Part B: Part C: All applicants to complete. Name of approved provider: Address of approved provider Street address / PO Box: Suburb: State: Postcode: Key personnel for this application Title: Given name(s): Family name: Position: Contact phone: Email address: Service ID (if applicable): Name of the aged care service:
Application to provide care This form replaces the previous four application Application for a determination that an approved provider is in a position to provide care – Residential Care Application for a determination that an approved provider is in a position to provide care – Home Care Application for a determination that an approved provider is in a position to provide care – Flexible Care Application for a determination that an approved provider is in a position to provide care – Transition Care This application may be submitted at any time before the end of the provisional allocation period. A decision to make a determination or reject your application will be made within 28 days after the Department receives your application. The Department will notify you of the outcome of your application. This form has three parts: Part A: All applicants to complete. Part B: Applicants for Residential Care to complete. Part C: All applicants to complete. Name of approved provider: Address of approved provider Street address / PO Box: Suburb: State: Postcode: Key personnel for this application Title: Given name(s): Family name: Position: Contact phone: Email address: Service ID (if applicable): Name of the aged care service:
att_a_-_application_to_provide_care.docx