Serious Illness and Emergency – Form

Funding to assist Members to attend the bedside of a terminally ill or seriously ill relative (who is a Member) may be available for:

  • Travel (between towns and cities).
  • Food

Other Key Factors

  • Only immediate blood or cultural relatives of the patient can be assisted.
  • Verification from the hospital or a doctor must be provided – e.g. a letter.
  • Funding will only be provided if other community or Government funding (e.g. PATS) cannot be obtained.

To apply, submit the form.

You will receive a confirmation email when your application has been received.


If your application is consistent with trust policies and budget you can expect approval within three business days.

Online Application Form

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Medical – attach your appointment note or letter and your PATS Application.
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    If you prefer you can download and email back the application form to