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Refer an Older Person to ACVVS

The Aged Care Volunteer Visitors Scheme connects eligible older people who may be feeling lonely or socially isolated with a caring volunteer for regular friendship and companionship.

This form can be completed by the older person, their representative, an aged care provider or an ACVVS coordinator.

The information provided will help us confirm eligibility and find a compatible volunteer match. All information will be kept confidential.

Leave the following field blank, it is an anti-spam field.


Care Recipient Details and Friendship Preferences (if applicable)

Please indicate if the older person being referred is from any of the below diverse, complex vulnerability and cultural groups (tick as many as apply) required
If face-to-face visits are paused during a residential aged care lockdown, which type of virtual visit would the care recipient prefer?

Visitor Preference

Additional Matching Information

Please include any other health or background information and/or preferences that will help match the aged care recipient with a compatible volunteer. Additional information about the care recipient could include:

Support at Home recipients ONLY

Referrer Details

Emergency Contact Details

Aged Care Provider Details