Palliative Aged Care in RACHs Mentoring and education program for GPs

COORDINARE is seeking interest from General Practitioners (GP) to participate in the Palliative Aged Care in Residential Aged Care Homes (RACHs) mentoring and education program. This program aims to foster a collaborative and well-informed care environment, ensuring that residents receive comprehensive and compassionate care. 

For any questions regarding this process please email Commissioning Business Team at commissioning@coordinare.org.au

Section A - Applicant details

Applicant name

Phone number

Title / position

AHPRA Registration Number:

Section B - Assessment criteria

Provide details of Residential Aged Care Homes (RACHs) you are attending:

Name of RACH(s)

RACH(s) Address

How often do you attend the RACH(s)

RACH contact details:

Name

Phone number

Title / position

What benefits do you anticipate your participation in the program will bring to the Residential Aged Care staff and residents?

Section C - Declaration and signature

If this application is successful, I am committed to participating in the project within the designated time frame.

If this application is successful, I agree to provide the required payment document (including invoice and paid participation form) to COORDINARE – South Eastern NSW PHN.

I understand and accept that information provided in this application may be stored by COORDINARE – South Eastern NSW PHN in various hardcopy and/or electronic formats.

I understand that this application does not create a legal or binding commitment and that if successful I will be bound by a contract with COORDINARE - South Eastern NSW PHN.

I understand that I am required to have current and adequate insurances in place. (e.g., Professional indemnity insurance).

I can confirm that the contents of this application are to the best of my knowledge accurate, complete and do not contain any false, misleading or deceptive misrepresentation, claims or statements.

I understand that if the conditions of the funding are not complied with, COORDINARE – South Eastern NSW PHN may seek to recover any funds allocated.

Applicant signature

Full name

Date