CarePath Program Enrolment

1
Thanks for your interest in the Senior Services Guide. Please enter your email below and we'll get this sent to you.* This field is required.
example@example.com
2
Would you like us to also include a FREE customised report detailing the different home support services you may be entitled to in your area?
YESNO
3
Ok then. So that we can customise the report to your specific situation, let's start by telling us who the home care is for?* This field is required.
Myself
Parent
Spouse
Someone Else
4
Great...and what is the aged of the person requesting care services?* This field is required.
<65 Years old
65 - 69 years old
70-79 years old
80 - 89 years old
>90 years old
5
Got it. Now, is there currently any home care support in place?* This field is required.
Yes
No
6
...and how often is this support provided?
Once per fortnight
1-2 times per week
3 or more times per week
7
Ok. So tell me, what are the current challenges?* This field is required.
Need more help at home
Need better quality service
Need lower fees
Something else
8
Ok...and has an assessment with My Aged Care been completed yet?* This field is required.
Yes
No
I don't know
9
Perfect! When was the assessment?
0-6 months ago
6-12 months ago
12-24 months ago
More than 2 years ago
I can't remember
10
...and what are the main health challenges you're living with?
Arthritis
Diabetes
Mobility challenges
Balance issues
Pain
Vision challenges
Hearing loss
Incontinence
Shortness of breath
Cognitive decline
Other
11
What sort of home support services would you like to know more about?
Home cleaning & domestic duties
Lawn & Garden maintenance
Transport to shops & doctors
Meal delivery
Physiotherapy
Podiatry
Personal care / Showering
Nursing
Social engagement and activities
Home maintenance & repairs
Mobility equipment & Daily living aids
Other
12
Are you approved for a Home Care Package?* This field is required.
Yes
No
I don't know
13
What level Home Care Package are you approved for?
Level 1
Level 2
Level 3
Level 4
I don't know
14
Have you noticed any changes in support needs over the last 6 months?* This field is required.
Needs have increased
Needs have decreased
Needs have remained the same
15
Has there been any recent falls or trips??* This field is required.
Yes, less than a month ago
Yes, more than a month ago
No, there have not been any recent falls or trips
16
Please enter your details below so we can complete your FREE customised report detailing the different home support services you may be entitled to in your area* This field is required.
Name
Please enter your postcode
Please enter your phone
17
Great, thanks. To provide you with information relevant to your local area, we'll also inform one of the local aged care experts we collaborate with about your situation.
I agree to have my information shared with a local aged care expert who can provide me with aged care information relevant to my needs.
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