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Third Party Provider Application

Business Details

Address

Compliance

The information uploaded here is secure and protected and only used for the purposes of pre-qualifying our supply partners.

Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
If you are a sole trader, please upload your current Police Check ( no older than 3 years). If you are a company with staff providing services, please upload your current Police Check procedure or a statement indicating that all your staff have current Police Checks.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
This is the list of current fees or a quote for services.

Declarations

Conflict of Interest

A conflict of interest can arise if you have a personal or private interest that could influence, or be perceived as influencing, your business dealings with Home Care Assistance Gold Coast. An example would be a family member or close friend who is an employee of Home Care Assistance Gold Coast.
Please note: a supplier who is a family member or other close associate of a client is excluded from providing services to that client, but may provide services to other clients.
Click or drag a file to this area to upload.
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We're committed to elevating In-Home Care, Sharing Our Expertise, and Supporting Care Workers which is why we are Internationally recognised as an Industry Leader