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Non-smoking Policy

Montefiore is a smoke free environment. Therefore, no consumer is permitted to smoke within the confines of the entire facility except in designated smoking areas outside the building.

Privacy Consent

For the purposes of your residence (or proposed residence) at Montefiore and the services we provide to you, we will need to collect, record and use personal information about you (including medical and financial information).

We seek your consent to the intended uses and disclosures of information where appropriate to:
  1. Appropriate organisations, such as government departments (in Australia and, for some consumers, in other countries), hospitals and other homes or hostels to which you may seek to move; and/or

  2. Medical practitioners, other health service providers, professional advisers and other appropriate persons, such as Guardians or other persons responsible under the Guardianship Act NSW (1987). As required to any third party including external service providers to claim for their services
In considering any disclosure to be made, we will bear in mind the maintenance of your privacy as an important criterion, subject to our need to perform our obligations and services.

By signing this form below, you signify your consent to our collecting, recording, using and disclosing, as we consider appropriate from time to time, personal information in relation to yourself. If you wish to limit any disclosure we may make, would you please delete “Nil” below and specify the limitations you require. Absence of consent may not necessarily preclude Montefiore from collecting, recording, using or disclosing such information

A copy of the Organisation’s full Privacy Policy is available from our office.


Signature and Declaration

By signing this Application you declare that the information given in this form is true and complete, you give the undertaking set out above in relation to change to any Power of Attorney and/or appointment of Guardian or Financial Manager and you provide the privacy consent set out above

If this Application is being signed by an authorised signatory (e.g. Guardian, attorney or person responsible), please insert name of signatory below and attach a copy of the relevant authorisation document.


When you click submit your information will be submitted

Contact Information