• Application for support submitted
  • Opportunity Close Date
     - -
    2 digit day, 2 digit month, 4 digit year

  • Application For Support

  • Hi there! Thanks for reaching out to us. 

    Little Dreamers supports young people aged 4 to 25 who provide or intend to provide care, support, or assistance for a family member affected by disability, chronic or mental illness, substance use, or frail age.

    This quick form helps us understand your situation so we can connect you with the right support. 

    • If you’re under 16, your parent or guardian will need to provide consent on your application form. 
    • Everything you share is private and only used to support you safely.

     

  • About You

    The following questions ask you a bit about what your caring role looks like - think about the responsibilities you have at home, how often you do these tasks and roughly how many hours per week you spend on providing care for your family member (it's ok for these to be estimates). This might include providing emotional support, helping with physical caring tasks like showering, toileting or helping with medication, or assisting with household tasks.
  • Birthdate*
     / /
    2 digit day, 2 digit month, 4 digit year
  • Format: 0000000000.
  • Preferred Contact Method*
  • Are you filling this form for yourself or someone else?*

  • Parent/Guardian Details

  • Format: 0000000000.
  • Consent terms signed

  • About Your Caring Role

    Tell us a bit about who you care for and what you do to help them.
  • Do any of the following identities or experiences apply to you?*
  • Aboriginal or TSL
  • 0/32768
  • How many people do you care for?*
  • Who do you care for?*
  • What are the health conditions, disabilities or support needs of the person you care for?*
  • What kinds of things do you help with?*
  • Caring Role Impacts*

  • About how you're going

    These questions help us understand how caring affects your daily life.
  •
  • Do you get time to do fun things or see friends?*
  • Does caring make it hard to keep up with school or work?*
  • Have you missed school or work because of your caring role?*
  • Have you ever been diagnosed with a mental illness?

  • Current supports

    Are you or your family already linked in with any services or programs?
  • Carer Services*

  • Getting in touch

  • Would you prefer your Intake and Assessment call to be over video or on the phone?
  • Do you require communication support for your Intake and Assessment Call?
  • Interpreter
  • How did you hear about us?

  • Consent and privacy

    We take your privacy seriously. The information you provide will be stored securely and used only to connect you with support. You can withdraw consent at any time.
    • I have read and understood the Privacy Policy Statement
    • I consent to being contacted by the Little Dreamers team
    • I consent for my data to be stored and used for program planning and evaluation
    • I agree for my data to be shared anonymously (i.e. names and contact details will be removed) for research and evaluation purposes.
    • As the parent/guardian of the above young carer, I consent to my child's data being shared anonymously (i.e. names and contact details will be removed) for research and evaluation purposes.

  • Sometimes, with your permission, we may share relevant information with other services to better support you or your family. This may include our Young Carer Wellbeing Hub, the Carer Gateway, or other specialist services (for example, mental health, family support, or community services).

    We will only ever share what is necessary, and we will talk with you before making any referrals. You can ask us to update or withdraw this consent at any time by contacting our team.

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