Ac019 2026

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4 out of 5

31 votes

The document outlines the process for appointing a nominee to act on behalf of a care recipient in residential aged care or receiving home care packages. It includes details on how to fill out the form, privacy notices regarding personal information, and declarations required from both the care recipient and the nominee. The form allows for the nominee to manage communication with the Australian Government Department of Human Services regarding care costs and financial information.

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Begin with PART A by entering the care recipient's details. Fill in their title, family name, and given names as required.
Provide the date of birth and care recipient ID if known. Next, enter the name and phone number of the aged care service.
Indicate whether the care recipient is mentally or physically impaired by selecting 'Yes' or 'No' for each question.
In PART B, if applicable, complete the nominee’s details and tick all forms of authorization held on behalf of the care recipient.
Ensure both the care recipient and nominee sign and date where indicated before submitting your form.

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