Referral Form

Privacy Statement

VitaliCare  is collecting your personal information so that we can assess your service needs and our ability to meet those needs.   We will not disclose your personal information outside of this organisation unless we are required by your funder, law or you have given your consent. However, in order to perform the above functions, we may need to disclose your personal information to Funders, Australian Government Department of Communities, Australian Government Department of Health, Queensland Health, Department of Veterans' Affairs, referring agency, general practitioner, external service provider(s), auditing bodies, aged care assessment team and national minimum data set. By completing and submitting this form, it is acknowledged that you have given us your consent to manage your personal information in the manner described in this abbreviated privacy statement.