New consumer sign-off

Housing and Support Program
New consumer sign-off–temporary vacancy
Once a temporary vacancy has been declared due to a consumer utilising a reduced amount of their allocated hours,
Mandatory form 2.7—Capacity notification is completed. Following a new consumer’s endorsement by the local Hospital
and Health Service (HHS) selection panel to access these unused hours, this form, Mandatory form 2.5-New consumer
sign-off—temporary vacancy is to be completed by relevant stakeholders. Both forms (2.7 and 2.5) are then submitted to
Mental Health Alcohol and Other Drugs Branch (MHAODB) for tracking and processing.
Temporary vacancies are only for a period of three months and must be utilised within the current financial year.
PLEASE RETURN THIS FORM TO THE MHAODB WHEN COMPLETED
Email: [email protected]
1. Details
Name of consumer
Temporary hours available
Vacancy details
(Where did the vacancy come from?)
Short term hours to be allocated to
above consumer
For what timeframe
From
to
Exit strategy for end of support
2. Endorsement
Name
Position
Service provider
Email
(must be authorised to sign on behalf of
the organisation)
Phone
Signature
Date
Name
Position
HHS
(must be authorised to sign on behalf of
the HHS)
Email
Phone
Signature
Date
Please confirm that the hours required will meet the short term
needs of the consumer
Yes
No
Mandatory form 2.5—New consumer sign-off—temporary vacancy: v2_December 2014

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