RESIDENT AND ACCOMMODATION AGREEMENT Residence: AminyaResident and Accommodation Agreement • May 3rd, 2024
This Agreement sets out the terms and conditions regulating the relationship between you and us. The following provisions are attached:
RESIDENT AND ACCOMMODATION AGREEMENT Facility: Windsor Aged Care ServicesResident and Accommodation Agreement • January 15th, 2018
Your Personal Details Name (You/Care Recipient) RESIDENT Date of Birth Current Address Billing Address Email Emergency Contact Name Address Phone Number(s) Email Representative(s) (if any) (eg enduring power of attorney, guardian, administrator, financial manager) Authority Name Address Phone Number(s) Email Authority Name Address Phone Number(s) Email Authority Name Address Phone Number(s) Email
RESIDENT AND ACCOMMODATION AGREEMENT Care Facility: Serene Residential Care ServicesResident and Accommodation Agreement • July 11th, 2014
Your Personal Details Name (You/Resident) RESIDENT Date of Birth Address Billing Address Emergency Contact Full Name(s) Address(es) Phone Number(s) Power of Attorney (Financial) (if any) Full Name(s) Address(es) Phone Number(s) Power of Attorney (Medical) (if any) Full Name Address(es) Phone Number(s) Guardian (if any) Full Name(s) Address(es) Phone Number(s) Administrator (if any) Full Name(s) Address(es) Phone Number(s)
