Participant Referral Form

Please note, we assess each referral with care. As a Disabled Persons Organisation our first priority is the wellbeing of people with disabilities. If we feel are unable to help, we will do our best to refer the participant to the most appropriate service. We triage our referrals and accept participants based on the need for our support, and not on the funding that is available. In cases where appropriate funding is unavailable we may be able to assist pro-bono (free) or at a reduced rate to put in for a plan review if appropriate.

Client Details

Other contact

NDIS Details

Referrer Details (Person Making the Referral)

Reason For Referral

Please include any specific requests such as preferred days and times.