You need to complete this form if you ceased arrangements with an existing associated provider (see Section 3: Changes to associated providers in Part D: Service delivery). 

Your response to these questions helps us to understand changes to your business structure.

Note: If your registration includes provider registration categories 4, 5 and/or 6, any changes to your arrangements with your associated providers in relation to those categories must be notified to us via a Change in circumstances notification (for more information see here).

Your response to these questions helps us to understand the circumstances around why another entity is no longer your associated provider. For example, you may have made arrangements with a different entity to provide services on your behalf and have added them as an associated provider (see Add an associated provider form).

You must also describe the impact, and any anticipated impact, the removal of the entity as your associated provider has had, or will have, on your delivery of funded aged care services. For example:

• details about any disruptions to the care received by older people once the entity no longer provided services on your behalf 

• whether you have undertaken to provide the services that the entity used to provide on your behalf or engaged a new associated provider to do so.