Aged Care Appointment of a Nominee form (AC019)

Use this form to authorise another person to deal with us on your behalf if you are in residential aged care or are receiving a home care package.

The person you authorise is known as a nominee.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

If you use assistive technology because of a disability or impairment we provide help for assistive technology users of forms.

Page last updated: 27 August 2017