A Professional Organising and Decluttering Service in Geelong, Victoria

    Date of Referral:

    Client's Details

    She/HerHe/HimThey/ThemPrefer not to say


    Referrer Details

    Is Funding Received Through Any of The Following?

    Self-FundedHome Care PackageDVA (Dept of Veteran Affairs)DFFS (Dept of Family, Fairness and Housing)Other Community Service Agency, e.g., Meli, Orange DoorNDIS (please fill out details below)

    NDIS Participant Information Required:

    Plan ManagedSelf-Managed

    NDIS Line Item:

    Home Management:

    (House & Yard Maintenance)-01_019_0120_1_1(Assistance with Personal Domestic Activities)01_004_0107_1_1(Assistance with Self-Care Activities)-01_011_0107_1_1(Specialised Home-Based Assistance for a Child)-01_016_0104_1_1(Access Community Social and Rec Activities)-04_104_0125_6_1(Skills Development and Training)-09_009_0117_6_3(Assistance with Decision Making Daily Planning and Budgeting)-15_035_0106_1_3(Skill Development and Training including Public Transport Training)-15_037_0117_1_3(Training for Carers/Parents)-15_038_0117_1_3(Assessment Recommendation Therapy or Training - Other Professional)-15_056_0128_1_3

    Residential House Cleaning:

    (House Cleaning & Other Household Activities)-01_020_0120_1_1

    Reasons for Referral:

    Home Management (decluttering, organisation, systems and functionality, hoarding tendencies)Residential CleaningHome Care (Non-NDIS clients)All of the above

    Description of Home: Include number of bedrooms; bathrooms; and/or garage


    Home Management - Areas of Concern:

    Clutter and disorganisationHoarding tendenciesStorage and functionalityPaperworkRoutines and systemsSafety HazardsRelocating

    Residential Cleaning - Areas of Concern:

    KitchenBathroom/sToilet/sVacuuming and mopping floors

    Home Care/Companion Care - Required Services:

    Meal preparationCooking/bakingCompanionship and socialisingShopping – aided or unaidedTransportationOther

    Health Conditions/Disability (assists with person centred care):

    Mental Health e.g., depression, anxiety, Bi-Polar, BPDAlzheimer’sABI (Acquired Brain Injury)Physical disabilityADD/ADHDAutismOther

    Any Additional Information:

    Photos are helpful to determine how we can help, please upload here:

    How did you find us?

    Friend/relativeGoogle SearchA Place of Calm WebsiteSocial MediaHoarding Home SolutionsColleagueOther