Viability Expansion Component and Homeless Supplement Assessment form (AC024)

Use this form to confirm eligibility of care recipients who meet the homelessness or Indigenous Australian additional special needs appraisal requirements.

You must complete both the assessment and confirmation sections of the form.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.
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Page last updated: 16 August 2017

This information was printed Thursday 17 August 2017 from humanservices.gov.au/health-professionals/forms/ac024 It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.