Financial hardship assistance for Home Care and Residential Respite Care form (SA462)

Use this form and guide to test your eligibility to receive financial hardship assistance with your fees and charges in Home Care or Residential Respite Care.

Residential Respite Care is assistance for the basic daily fee.

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

If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.

Page last updated: 9 April 2018