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Application for Respite Care or Permanent Entry to Aged Care Homes

This form is used by an approved provider or authorised agent of a Commonwealth funded aged care service for new residents - respite or permanent.

This application form can be downloaded and printed from this website. Instructions on completing this form can be found below.

Application for Respite Care or Permanent Entry to an Aged Care Home (PDF 1959 KB)

Applying for a Place in an Aged Care Home Respite Care or Permanent Entry

Applicants for residential aged care usually complete an application form. A standard application form that can be used across Australia can be downloaded from this site. This form only has to be completed once, photocopied, signed and sent to each aged care home to which you wish to apply.

What you need to do before applying?

Step 1: Assessing your eligibility

The person applying for a place must have a current Aged Care Assessment Team (ACAT) approval for residential aged care.

A list of local Aged Care Assessment Teams is available online.

Step 2: Finding a home

Once a person has been assessed by an ACAT as eligible for Commonwealth funded residential aged care, he or she may choose to start looking for an aged care home.

For information about aged care homes in your area, contact Freecall 1800 200 422* (* mobile calls are charged at applicable rates)

Step 3: Applying

The standard application form is available from many places including:

• The local ACAT;
• By calling 1800 200 422;
• Aged care homes.
• Online (PDF 1959 KB)

Applying for Permanent Entry into Residential Aged Care:

1. Download the Application Form
2. Complete the application form in blue or black pen
3. Make clear photocopies of :
   • The completed Part A (unsigned)
   • Your ACAT approval form
   • Sign all photocopies and give a set to each aged care home to which you are applying. Keep all originals as they may be required at the time you enter the home.
4. At some stage complete Part B - Further Information. Provide this to the aged care home when you are offered a place.

Applying for Respite Care in a Residential Aged Care home:

1. Complete the application form in blue or black pen
2. Make clear photocopies of :
   • The completed Part A (unsigned)
   • Your ACAT approval form
   • Sign all photocopies and give a set to each aged care home to which you are applying. Keep all originals as they may be required at the time you enter the home.
3. Complete Part B - Further Information Provide this to the aged care home when you are offered a place.

Need assistance completing the Application Form or more information on entering residential aged care?

The Application Form may be filled in by someone other than yourself, e.g. a carer, a member of your family or a friend.

To contact your local Aged Care Assessment Team or for information on aged care generally, please call the Aged Care Information Line on 1800 200 422.

An information booklet '5 Steps to Entry into Residential Aged Care', designed to assist you to complete the application form, is also available from these outlets.

If you are having problems downloading these PDF files please contact 1800 200 422 to arrange a copy of this book.
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