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Make a referral

Refer yourself or someone else for support. We review referrals and aim to respond within 2 business days.

NDIS Registered Provider

Use this form to refer yourself or someone you support. Family members, carers, coordinators, advocates, and health professionals can all use this form.

Private and respectful Clear communication Advocate or family welcome
Participant aware
Please make sure the participant knows about the referral where this is required.
Suburb or postcode ready
We use location details to quickly check whether we can support the area.
Support summary ready
A short summary is enough. Please do not include unnecessary identity numbers or extra documents.
Who is making the referral?
Please enter your name.
Please enter a valid email address.
Please enter a valid Australian phone number (mobile or landline).
Please select your role.
Please enter any additional notes about the referral. No sensitive info.
Participant information

Privacy notice: We collect participant information so we can review the referral and decide whether we may be able to help. Please include only the information we need for that purpose. See our Privacy Policy.

Please enter the participant's first name.
Please enter a valid 4-digit postcode.
Please provide a brief summary of the participant's needs. Please do not put sensitive information such as NDIS ID, DOB, etc..
Services Required (check all that apply)
Select at least one service.
Consent and declaration
You must confirm participant consent to submit this referral.
You must acknowledge our privacy policy to proceed.

We handle participant information in line with the Privacy Act and relevant NDIS requirements.

You must consent to proceed.

We receive the referral

We receive the referral and review the details provided.

We review support fit

We check service fit, location, and whether we need more information.

We follow up

We aim to contact you within 2 business days with the next step.

Please only include information we need to assess the referral. If we need more information, we will contact you directly.

Questions about the referral process?

Call us or send a message and we will talk you through it.

Contact Us Call 0435 335 444
Call Us Make a Referral