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Aged Care Referral

For aged care providers and care managers arranging cleaning, lawn and garden care, or maintenance services. Clients and authorised family members are also welcome to refer.

Please include the client’s contact details, an emergency contact, the provider, care manager, requested services and invoice instructions. Approval and budget details can be included if known. If approval or details are still being arranged, write Not yet confirmed.

We will discuss availability, a quote and any provider onboarding or work-order requirements. A referral does not confirm a booking or funding approval. Funded work will be arranged with the relevant provider before services begin.

Only share information you are authorised to provide. Please do not send full care plans, medical records or access codes through this form. Privacy policy.

Just have a question? Send a general enquiry. For an NDIS participant, use our NDIS referral form.

Aged Care Service Request

1. Referrer details

Use this form to request services and provide the details needed for a service agreement. Fields marked * are required.

2. Services requested

Choose one or more services. Only the questions relevant to your choices will appear.

Cleaning

Minimum 2 hours per visit.
Cleaning visits have a 2-hour minimum.
Tell us which rooms or tasks need particular attention.

Garden care

Our standard schedule is weekly in summer, fortnightly in spring and autumn, and monthly in winter. You can request an alternative for us to discuss.
Tell us the schedule you would prefer. We’ll discuss availability and agree on arrangements with you.

Maintenance

We’ll discuss materials, costs and payment arrangements before confirming the work.

3. Client details

Provide the details we need to arrange services safely.

Optional. DD/MM/YYYY, if needed for the service agreement.
Leave blank if the client does not use a phone.
Optional.
Include street address, suburb, state and postcode.
Name, relationship, phone and email.
If none is available, write None available so we can discuss this.
Write N/A if no emergency contact is available.
Write N/A if no emergency contact is available.
Include relevant pets, access arrangements, product sensitivities or communication needs. Please do not include key codes or medical records.

4. Provider, approval and invoicing

Tell us which aged-care provider is arranging the services. You can leave optional details blank if they are not yet known.

Write Not yet confirmed if a provider has not been confirmed.
For example, the program named by the aged-care provider.
If known.
Include any approved tasks or limits relevant to this request.
Start and end dates of the provider’s approval. We will discuss the first visit with the client.
Optional. Include any budget or spending limit the provider has supplied. Otherwise, leave blank.
Leave blank if invoices go to the provider named above.
If known. We will confirm invoicing arrangements with the provider before services begin.
Include any work order, supplier setup, invoice format or service-report requirements. Please do not include confidential care plans.

5. Agreement and consent

Tell us who should receive the quote or service agreement for review.

For example, care manager, client or authorised representative.
Name, relationship and email, with the client’s permission.
We use these details to contact the people nominated and prepare service arrangements. Submitting this form does not confirm a booking, provider approval or a signed agreement.