Referral form

Make a referral

Three things are enough to start. The rest is optional, and you can save your answers and finish later. We reply promptly, to you.

  • Who you are and how to reach you
  • The person’s first name and area
  • The support they are looking for
A young woman with Down syndrome writing on a weekly planner at the kitchen table with a support worker.

Referral form

Six short steps, and no time limit. Please do not paste medical reports into the form: we send you a secure way to share documents after we reply.

  1. About you
  2. About the person
  3. What support
  4. Funding
  5. Consent
  6. Review and send

All six sections are below.

About you

So we know who to reply to.

We reply to this address.

About the person

A first name and an area are enough to start. If you are referring yourself, tell us about you.

Where they live now, or where they would like support.

For example, a preferred language, a communication device, or needing more time to answer.

What support

Which support are you asking about?

Choose any that apply.

In the person's own words if you can.

Keep it brief and leave out medical detail. For example, needing two workers for transfers, or a known trigger to avoid.

Funding

Skip anything you do not know yet. The NDIA decides what a plan funds, not us.

Self-managed means the person or their nominee pays providers. Plan-managed means a plan manager pays invoices. NDIA-managed means the NDIA pays registered providers directly.

SIL is daily support in a shared or single home. Only answer if you are asking about SIL.

Not needed to start a referral. You can give it to us later.

Consent

Review and send

Check your answers above, then send.

We use these details only to respond to this referral. Read our privacy policy.

Saving keeps your answers in this browser on this device only. Nothing is sent until you press Send referral. On a shared computer, clear saved answers when you finish.

Questions

About this form

Do I need the person’s NDIS number or plan?

No. Both help later, but three things are enough to start. If you have them, you can add the NDIS number in the funding step, and we send you a secure way to share the plan after we reply.

Why do you not ask for a diagnosis or date of birth?

We ask only for what we need to reply and to start planning. Anything clinical is better shared securely, later, and only if it helps plan the support.

What does “Save and finish later” do?

It keeps your answers in this browser, on this device only. Nothing is sent to us until you press Send referral. The saved answers are cleared when the referral sends, or when you choose Clear saved answers.

I would rather talk than fill in a form.

That is fine. Ask for a call back and we will ring you at a time that suits.

More answers for referrers are on the support coordinators page.