Westmont Respite Admission Checklist

To ensure that your admission is as smooth as possible it would be appreciated if you could please check of all of the following items prior to your arrival. Please return all relevant information to Westmont at the requested time.

Check list Items

Items 1 - 5 to be returned to Westmont 1 week prior to admission *

1. Application Form 2. Aged Care Assessment (Copy)3. Referral Codes ..........................4. May Aged Care Fee Estimator5. Pre-Admission Assessment completed.

Access My aged Care Fee Estimator from this link My Aged Care Fee Estimator

Please email completed My Aged Care estimator to admin@westmont.org.au

Additional Check List Items

Current medication chart (must be completed by a doctor)Health Care Summary (must be completed be a doctor).Webster Pack (from Pharmacy).Vaccination StatusPower of Attorney, if applicable.Goals of Care plan to be completed.Wallet Id. (originals must be sighted e.g. Pension Card, Medicare Card, Health Care Card)Environment Restraint signed (can be done at time of admission).Continence Aids, if required, for duration of stay.All clothing to be labelled, unless washing being attended to be by family

Upload a copy of your medication chart here

Browse

For further assistance

If you would like further assistance with this check list please fill in the optional name, telephone and email details and click the submit button below:

Name:

Date

Telephone number or mobile:

Email address:

Please wait, files are uploading..

Save and Complete Later

Your progress is saved.

When you're ready to complete your form submission, use this form link:

Copy URL