Consumer Intake Forms

Page Under Development, Awaiting Approval – the intention is to replace page https://homeassist.org.au/referral-forms/ once approved for use.

Choosing the Right Form for You

Are You a New Consumer? First Time with Home Assist?

Your choice of Form is simple. All consumer journeys with Home Assist start with a Registration Inquiry form to check your eligibility.

Click Here To go the Registration Enquiry Form

Do You wish to enquire on behalf a New Consumer? Are You Registering a New Consumer with Home Assist?

All consumer journeys with Home Assist start with a Registration Inquiry form to check eligibility of the consumer. Please complete the enquiry form on behalf of the consumer you represent.

Click Here To go the Registration Enquiry Form

Are You Looking for a Major Modifications Form?

There are 2 Form choices relevant to Major Modifications.

Commonwealth Home Support Programme (CHSP) Major Modifications Form

This is where you find the CHSP Major Modifications form

Major Modifications Form for (HCP) Home Care Package Major Modifications (over $3,300.00)

This is where you find the HCP Major Modifications form

Are You Looking for a Minor Modifications Form?

There are 3 forms to choose from which relate to Minor Modifications Requests.

Minor Modifications CHSP, DVA, Private

Minor Modifications HCP, STRC

NDIS Minor Modifications Referral Form

Are You Looking for a CHSP Form (Commonwealth Home Support)?

There are 2 forms to choose from which relate to Commonwealth Home Support (CHSP)

CHSP Major Modifications form

Minor Modifications CHSP, DVA, Private

Are You Looking for a Home Care Package Form (HCP)?

There are 2 forms to choose from which relate to Home Care Package (HCP)

HCP Major Modifications Form

Minor Modifications – HCP and STRC / Home Maintenance and Spring Cleans

Are You Looking for an NDIS Form?

There is one NDIS form available

NDIS Minor Modifications Referral Form

Are You Looking for a Short-term restorative care (STRC) Form?

There is one STRC related form available

Minor Modifications – HCP and STRC / Home Maintenance and Spring Cleans

Are You Looking for a Department of Veterans' Affairs (DVA) Fomr?

There is one DVA related form available

Minor Modifications Referral Form CHSP, DVA, Private

New Consumers

Please complete and submit this online form to check your eligibility.

Form Reference Number 6

Major Modifications (CHSP)

Commonwealth Home Support Programme (CHSP) Major Modifications

Form Reference Number 1

Major Modifications (HCP)

For Home Care Package Major Modifications (over $3,300.00)

Form Reference Number 4

Minor Modifications CHSP, DVA, Private

Minor Modifications Referral Form CHSP, DVA, Private

Form to be completed by Occupational Therapists for minor modification requests.

Form Reference Number 0

Minor Modifications
HCP / STRC / Home Maintenance

Minor Modifications – HCP and STRC / Home Maintenance and Spring Cleans

To be completed by Occupational Therapists for minor modification requests.

Form Reference Number 00

NDIS Referrals

NDIS Minor Modifications Referral Form

Form to be completed by Occupational Therapists for minor modification requests.

Form Reference Number 5.5