Nursing Home and Nursing Home Respite Care

Type Nursing Home
Description

Please note that all Nursing Home referrals must be submitted through IRMS.

Declaration Form (Consent Form) and all Subsidy Deviation Forms (if required) should be added as attachments to the IRMS Nursing Home Application

Form
  1. Residential Services Referral Form
  2. Declaration Form for Residential Services Application 2018
  3. Subsidy Deviation Forms (if required)
  4. RAF Form
  5. Social Report Checklist 2017
  6. Nursing Home Information Toolkit
  7. Guidelines on the use of the Resident Assessment Form (RAF) in Nursing Homes (July 1999)
Type Nursing Home Respite Care (NHRC)
Description Please note that all respite care referrals can be submitted through IRMS from 1 April 2015 onwards
Form
  1. NHRC Referral Form
  2. NHRC Social Report
  3. NHRC Declaration Form
  4. NHRC Medical Report
    • In accordance to MOH guidelines, a chest x-ray result of no more than 6 months is needed for nursing home admission
    • An inpatient discharge summary of no more than 6 months can be submitted in place of the medical report
  5. RAF
    • RAF is required if an inpatient discharge summary is submitted
Contact Information
enquiries@aic.sg
6820 0730

Community Case Management Service (CCMS)

Type Community Case Management Service (CCMS)
Description

Please note that all CCMS referrals are currently received through hardcopy submission.

Please complete all sections of the form for the application to be processed successfully. Include the latest doctor's memo/Discharge Summary and Social Report (if available).

Form
  1. CCMS Referral Form
Contact Information
careconsultant@aic.sg

Community-based Service

Type Community-based Service
Description

Please use this form if patient requires services for

  • Day Rehabilitation
  • Day Care / Maintenance Day Care
  • Dementia Day Care
  • Centre-based Nursing
  • Home Medical
  • Home Nursing
  • Home Therapy
  • Home Personal Care
  • Meals on Wheels
  • Medical Escort and Transport

Form
  1. Community Services Referral Form
Contact Information
6603 6800
6820 0730

Sheltered Home and Senior Group Home

Type Sheltered Home and Senior Group Home
Description

Please note the Sheltered Home and Senior Group Home referrals must be submitted through IRMS (effective 1 Oct 2018).

Declaration Form (Consent Form) and supporting documents such as PT/OT report (where required), bank statement and CPF statement and other supporting documents should be added as attachments to the IRMS Sheltered Home/Senior Group Home Application.

Form
  1. Residential Services Referral Form
  2. Declaration Form for Residential Services Application 2018
Contact Information
socialhomes@aic.sg
6820 0730

Psychiatric Sheltered Home

Type Psychiatric Sheltered Home
Description

Please note that all Psychiatric Sheltered Home referrals must be submitted through IRMS.

Please complete all relevant sections of the form for the application to be processed successfully. Declaration Form (Consent Form) and all other supporting documents (if required) should be added as attachments to the IRMS Psychiatric Sheltered Home Application.

Form
  1. Declaration Form for PSH Application
Contact Information
6820 0730

IRMS Change Request Form

Type Change Request
Description

Please use this form for

  • Any change in Biodata information
  • Change of admission date
  • Cancellation of admission

Form
  1. Change Request Form
Contact Information
6603 6995 ( ILTC Portal Helpdesk )
6820 0730