Aged Care Volunteer Visitors Scheme

Care Recipient Referral Form

This form is used to refer an older person living in a Residential Aged Care Facility or living in their own home and approved for or receiving a Home Care Package (referred to as the Care Recipient) to the Aged Care Volunteer Visitors Scheme (ACVVS).

This form is to be completed by the aged care provider representative, ACVVS auspice coordinator, the Care Recipient, or their representative. The Aged Care Volunteer Visitors Scheme is funded by the Australian Government.

For more information visit our website: svsa.org.au/acvvs

Or visit the Department of Health and Aged Care's website: health.gov.au/our-work/aged-care-volunteer-visitors-scheme-acvvs/about


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