Carer Community Support Coordination/Parenting Program Application & Wait List
No questions are mandatory!
If you are a referring third party helping complete this form, please add your info here:
How did you hear about The Carer Community?
Parent/Carer Name
First Name
Last Name
Which are you interested in joining?
Please Select
Carer Community Parenting Program
Carer Community Support Coordination
Not sure yet, I'd like more info and a chat
Where do you live?
Best contact number to call/text you on
Email
example@example.com
Are you currently in crisis?
Please visit www.askizzy.com for immediate support.
Any major life events coming up soon for you & your family that are worrying you?
Why do you need a new support coordinator?
What do you need most right now from a support coordinator?
Are you funded for support coordination?
Aboriginal or Torres Strait Islander
Please Select
Yes
No
Other - no answer
If switching from another support coordinator, have you had this conversation with them yet?
If switching from another support coordinator, is organising a handover of their work with you going to be an option?
Names and ages of all NDIS participants in the household & their disabilities/accepted diagnoses (please specify which participants are requiring services)
Names and ages of all who do not have NDIS plans in the household
Does anyone in your home need an NDIS plan but hasn't accessed the scheme yet?
Community & Mainstream Supports
Let's create your optional to-do list while you wait for support coordination services or to join our program. Which of these mainstream supports are you currently accessing?
Parent Wellbeing Support
Progress & Relevance Status
Mental Health Care Plan or other professional support for Parent Carer
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Diagnosis Needed for Parent Carer
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Regular counselling or therapy for Parent Carer
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Medication Changes required urgently for Parent Carer
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Emergency Dental needed for Parent Carer
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Psychiatrist needed for acute mental health, medication management and referrals
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Child Participant Health & Wellbeing Support
Progress & Relevance Status
Further Diagnosis Needed
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Medication Changes required urgently for child
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Child with developmental delay diagnosis requires a DSM 5 Intellectual Disability assessment after age of 6 for next NDIS review
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Emergency dental needed
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Disability friendly dentist needed - Child Dental Benefits Schedule
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Child & Adolescent Psychiatrist needed for acute mental health, medication management and referrals
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Child requires transfer from pediatrician to appropriately skilled psychiatrist due to age
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Centrelink
Progress & Relevance Status
Carer Allowance
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Carer Adjustment Payment
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Health Care Card (for child)
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Carer Payment
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Additional Child Care Subsidy
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Post 16 Carer Allowance and HCC
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Disability Support Pension (from age 16)
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Youth Allowance - Study Reduced Load
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Assistance for Isolated Children (AIC) - home or distance education
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Medicare
Progress & Relevance Status
Aware of Medicare Safety Net & Limit
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Confirm Family in Medicare Portal
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Check right threshold is in place
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Chronic Disease Management Plan
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Mental Health Care Plan
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Medicare Item 135 - Autism - 20 Allied health session for under 25’s
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Child Dental Benefit Schedule & How to Access
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Aware of PBS Safety Net for Medications
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Add children over 14 back onto your Medicare card for Safety Net purposes
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Financial Wins or Supports
Progress & Relevance Status
Cancel unused subscriptions
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Car registration discount for concession card holders
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
NILS loan eligibility & how to apply
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Call bank to consolidate/reduce interest rate on credit card debt
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Refer to Salvation Army for budgeting/financial advice
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Check for lost Superannuation
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Get tax returns up to date to get any refunds and keep other government rebates up to date
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Check Health insurance for anything that can be claimed
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Update Centrelink income estimate for accuracy of FTB payments and childcare subsidy amounts
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
MoneySmart Unclaimed Money Search for all family members
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Energy Rebates
Progress & Relevance Status
Home Energy Rebates/Assistance (State based)
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Medical Cooling and Heating Scheme
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Concession for life support equipment eg CPAP
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Energy concessions for pensioners or low income
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
In Home Support
Progress & Relevance Status
Apply for Carer Gateway funding package
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
In Home Care - suitability, eligibility, application
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Download Kiddo app to find and trial support workers.
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Hire school holidays Au pair
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Additional Childcare Subsidy suitability, eligibility, application
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Community Support
Progress & Relevance Status
Need an MLA Key (Master Locksmith Universal Disability Bathroom Access Key
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
National Assistance Card - community explainer card to facilitate access and increase mutual understanding while advocating for child
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Companion Card for all eligible children
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Disability Parking Permit to be kept with child for your & their Worker’s vehicles
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
State Government
Progress & Relevance Status
Sports Vouchers
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Free broadband if school aged child in home - School Student Broadband Initiative SSBI School Student Broadband Initiative
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Fee free TAFE training (for parent or young adult)
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Discount Taxi Scheme
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Siblings
Progress & Relevance Status
Register siblings for Young Carers
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Apply for Little Dreamers
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Young Carer Grants
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Register siblings with Carer Gateway
✅ Already sorted
📝 On my list, just haven’t done it yet
🤔 Know what it is, not sure if it’s for us
❓Not sure what it is or if it’s relevant
🚫 Know it’s not relevant for us
Are you ready to get started with us now, or is this more of a later thing?
Anything else you want us to know?
Thanks, that's all we need!
We'll reach out once there's availability with a support coordinator or parent coach, to check if you'd like to commence in a certain month or timeframe, or if we need to ask any more questions from you.
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