Family Assistance Program - Going Home Pack

Supporting our most vulnerable families in need

The Lifes Little Treasures Family Assistance Program – Going home pack, is designed to provide the most vulnerable members of our community with a gift pack of items to support them in taking their baby home. Items may include baby monitors, thermometers, and baby clothes. In this program, a Social Worker / Hospital health professional evaluate families’ needs by considering several factors, gestational age of child at time of birth, length of stay in the hospital and the severity of circumstances *Please note items supplied may vary depending on the stock at the time the application was approved.

Nomination criteria

Below are our qualification guidelines for nomination:

The family must currently have a baby in NICU/SCN
The family is experiencing extreme financial pressure because of their baby’s hospital admission
Was born at 32 weeks or earlier or has a major health complication requiring a long stay in hospital of 4 weeks or more
Families from disadvantaged, Indigenous, Torres Strait Island backgrounds or rural or regional locations will be prioritised.

*Exceptions to the above may be made on a case-by-case basis. Please call Karen Peters to discuss on 0466 406 751

How do I nominate a family for support?

Step 1 – The Social Worker / Hospital Staff completes the family nomination form below

Step 2 – LLTF contacts the nominated health professional via phone/email to confirm approval of the application

Step 3 – If approved, LLTF will courier the pack to the nominated staff member who will present the pack
to the nominated family on behalf of LLTF . Please allow 7 working days from approval.

Family Assistance Application Form

Please nominate a family currently staying in your NICU/SCN but completing the form below. All sections must be completed for your application to be reviewed. Please provide a brief description as why the Keeping Families Together packs would benefit this family.

Please provide a brief description of why this funding is needed

Does this family meet any of the following:

Health Professional

Consent to support LLTF in funding applications

In order for LLTF to continue this program please confirm that you would be happy to provide LLTF with a short testimonial on why this program and Life’s Little Treasures makes a difference to the families in your hospital.

First Name

Last Name

Hospital

Hospital Department

Job Title

Work Phone

Mobile

Mailing Address (we can not deliver to PO BOX)

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First Name	Last Name
Mobile Phone	Home Phone
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