Contact Us

Contact Details

P: 1300 052 057
M: PO Box 422, South Hobart, 7004
A: Head Office
364 Macquarie Street, South Hobart 7004
Office also located in Burnie and Launceston regions but by appointment only due to operating hours. 

IHC Support Agency Tasmania

In Home Care Family Application Form - Tasmania

    Please note: This is an application only. Suitability for In Home Care will be assessed through the development of a Family Management Plan developed in collaboration between the family and the In Home Care Support Agency.

    Person completing or supporting the family to complete the application: Parent/GuardianOther

    Some families may need assistance in the completion of the IHC Application form or you may need to make a referral on their behalf (privacy law applies). Please note that this is an application form only. The first step for families is to register through their MyGov account to ensure they are eligible for Child Care Subsidy (CCS). As soon as this is determined, complete and submit the IHC application form. A representative from the IHC Support Agency will contact the family to assess against the IHC criteria, their suitability for the IHC Program.


    Parent/Guardian One:


    Employment Status:

    Add second Parent/Guardian: YesNo

    Parent/Guardian 2


    Employment Status:

    Were you assisted by a support person to complete this application? YesNo

    Are you (the family) registered and eligible for Child Care Subsidy?
    (You need to be registered and eligible to receive Child Care Subsidy prior to lodging this application)

    Child Details

    Number of Children:

    Child 1 Full Name:
    Child 1 Date of Birth:

    Child 2 Full Name:
    Child 2 Date of Birth:

    Child 3 Full Name:
    Child 3 Date of Birth:

    Child 4 Full Name:
    Child 4 Date of Birth:

    Child 5 Full Name:
    Child 5 Date of Birth:

    Family Suitability for IHC

    Families applying for In Home Care must be eligible for the Child Care Subsidy and can demonstrate that other types of approved child care are not suitable or available; and where one or more of the following criteria apply:

    Reason(s) for Application:
    working non-standard or variable hours, outside normal child care service hoursgeographically isolated from other types of approved child carechallenging or complex needs, including where families are experiencing challenging situations, and other approved child care services are not able to meet the needs of the child or the family

    Please provide other relevant family circumstances below: