Modifications Form

Modifications Request Form

Use this form to request a modification to your property. A modification is a change to the structure, layout or fittings of the property so you can safely access and move around it.

Bridge Housing will undertake and finance the work at no cost to the tenant, where it is feasible and economically viable to do so.

Disability modifications generally improve the accessibility of the property. Examples include grab rails, lever style taps and door widening. We generally need you to provide an Occupational Therapist Report or evidence from your doctor or support provider to help us assess your request.

Safety modifications are designed to improve safety in domestic violence situations. Examples include the installation of sensor lights, security screens, and the pruning of trees and shrubs.

Please see the Alterations and Disability Modifications Policy for more information.

Full Name *

Address *

Email Address

Contact Number

Please enter at least one contact method

Details of modification

Please select the type of modification from the options below:

Other

Any additional information

Support provider details

Do you receive any government support through the NDIS or MyAgedCare? *

Yes, I have an NDIS planYes, I receive MyAgedCare servicesNo, but I have recently appliedNo

If you answered yes to the above, does your plan include funding for home modifications?

YesNo Unsure

Please provide the contact details for your NDIS Planner or Aged Care Provider:

Organisation

Case manager/planner name

Email

Phone number

Please upload a copy of your Occupational Therapist Report and/or any other supporting evidence

Browse

Please upload copies of any quotes or further information to support your application

Browse

Conditions of Approval

This form must be completed fully and signed to be processed. You will receive a written response within 21 days.

Please note the following conditions of approval for modifications to a property:

I have submitted an Occupational Therapist report and relevant medical reports outlining the modifications required.
I have provided evidence that I am eligible or ineligible for support under the National Disability Insurance Scheme.
I have provided the contact details for my NDIS or MyAgedCare service provider.

Name

Your Signature *

Clear

Date Signed *

Bridge Housing's Privacy Policy describes how personal information about you is collected, stored, shared to external parties and discarded in accordance with the NSW Privacy Act 1998.