Consent to release an electronic Aged Care Client Record form (AC010)

Use this form to prove that a care recipient or nominee has consented that an aged care service or Aged Care Assessment Team can request a copy of their electronic Aged Care Client Record.

Aged care services include Residential care, Home care and Multi Purpose Services.

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

Page last updated: 13 February 2019