Mt Kooyong Nursing Home – Resident Applications

Thank you for your interest in Mt Kooyong Nursing Home, located at Julatten on Cairns’ Atherton Tablelands. We are always accepting applications for new residents. Applications can be submitted through the below online form, or by printing, completing and returning our downloadable Application Form.

Person completing the application

First Name

Last Name

Email

Telephone

Mobile

Relation to the applicant

Applicant

First Name

Last Name

Date of Birth

Marital Status

Religion / Organizational Affiliations (optional)

Country of Birth

Preferred Language

Does the applicant you have a current ACCR (Aged Care Client Record) and your letter of approval from the Dept of Health & Ageing

What level of Care do they require?

Do they hold an Australian Pensioner Concession Card:

Do they have Private Health Insurance? (eg. MBF, Medibank Private)

To assist the Home gain an accurate indication of the applicant’s requirements, please describe any conditions we would need to take into consideration.

For more information, please don’t hesitate to contact us directly on phone (07) 4094 1279 or
email admin@mtkooyong.com.au

Mt Kooyong Nursing Home – Resident Applications

Downloadable