ENQUIRE

A PROUD PROVIDER OF SUPPORT AT HOME

SUPPORT AT HOME FORM

As you grow older, you may find that you need extra support to continue living at home. This is where a Support at Home can help.

Support at Home is a government-funded program that allows older people to receive care services in their own home, so they can live independently for as long as possible. It can be used to receive all kinds of support, such as help with housework, transport to appointments or personal care.

Support at Home gives you choice and control over your care. Once you have received a package, you are free to choose us as your provider to work with you to create a care plan that best meets your needs. The government then subsidies our services to your home.

Participants Details

Next of Kin Information

Care Manager Details: 

Treatment Conditions 

  1. Please note that all appointments are subject to our 24-hour cancellation policy. If you can’t make your appointment, please notify your treating professional at least 24 hours before it is scheduled. If you miss an appointment due to being unavailable and did not give notice, the full fee will be charged, however we will give consideration to unforeseen circumstances. 
  2. Revital Healthcare does not accept responsibility for the treatment received by the participant. The patient and individual therapist are responsible for any professional liability.
  3. Revital Healthcare has assurance protocols in accordance with each relevant governing health service body and clinical guidelines.

Consent Details 

To be completed either by the client or the client’s representative or next of kin 

Relationship to participant (if being completed by guardian/parent): 

We look forward to working together towards your goals, here at Revital Healthcare