EOI Form - Supported Accommodation

First name

Last name

Phone

Tell us about you

Support Coordinators Name

Support Coordinators Number

Support Coordinators Email

How is supports funded

What are your plan managers details.

Which Location are you interested in?

What supports do you require? Please note there is a minimum of 28 hours of supports (any combination) per week required.

Assistance with daily living

Assistance with Household Tasks - there is a minimum of 2 hours per week for each person in the house or villa

Concierge Service

Participation in Community, Social and Civic Activities

Group and Centre Based Activities

Assistance in Coordinating or Managing Life Stages, Transitions and Supports

Development of Daily Living and Life Skills

Finding and Keeping a Job

Individual Social Skills Development

Do you have NDIS accommodation funding. If yes, please provide details.

Do you have SIL funding (Please note you DO NOT require SIL funding). If yes, please provide details.

Do you have a behavior support plan in place? If yes please give a brief overview.

Are you on any restrictive practices in place?

Do you have any special dietary needs?

Tell us about your interests and hobbies.

When would you like to move into our supported accommodation?

Please upload any reports or other information you feel would be helpful for us to know.

PLEASE NOTE BY COMPLETING THIS EXPRESSION OF INTEREST FORM, IT DOES NOT MEAN YOU WILL BE OFFERED A ROOM IN ONE OF OUR SUPPORTED LIVING HOMES. I have consent to submit this information. Please insert your Signature

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ANOTHEN Community Care

ANOTHEN Community Care
EOI Supported Accommodation

ANOTHEN Community Care

ANOTHEN Community Care EOI Supported Accommodation

ANOTHEN Community Care
EOI Supported Accommodation