Higher Everyday
Living Change

Cease Additional Services or Submit a change request for Higher Everyday Living Services

If you would like to cease Additional Services or change or cancel any Higher Everyday Living Services received by a resident at one of our Opal HealthCare Communities please fill in the details below.

Please be advised that within the first 28 days of agreeing to purchase the Higher Everyday Living Services from us, you can change or cancel the services without notice. After this initial cooling off period, you can always change or cancel services by providing us with 28 days’ notice.
Any submitted variation request is made subject to and in accordance with your Higer Everyday Living Agreement (HELA).

I am completing on behalf of the resident

I am the resident

Resident Details

Resident First Name*

Resident Last Name*

Resident Number (eg CN00XXXXX as per your fee statement)*

Care Community Name*

If this form is completed by others for the resident - please add.

Your First Name*

Your Last Name*

Your Email*

Your Mobile/Phone*

Authority to act for the resident (e.g. EPOA, Guardian)*

Change details are required for every submission

Please provide details of the services that you wish to change or cancel*

Download and Print Change request form

Cease Additional Services or Submit a change request for Higher Everyday Living Services

Resident Details

If this form is completed by others for the resident - please add.

Change details are required for every submission

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