NDIS Referral

Make a Referral

Refer a participant to Disability Dream Care. Our team will review your referral and be in touch within one business day.

Participant Details

First Name

Last Name

Date of Birth

Gender

NDIS Number 9-digit NDIS participant number

Plan Management Type

Plan Start Date

Plan End Date

Participant Contact Details

Phone Number

Email Address

Street Address

Address Line 2

Suburb

State

Postcode

Preferred Contact Method

Best Time to Call

Referrer Details

Referrer Type

Your Name

Organisation

Your Phone

Your Email

Relationship to Participant

Additional Information

Support Goals

Urgency Level

Current Living Situation

How did you hear about us?

Consent

I confirm the participant has provided consent for this referral, or I am authorised to act on their behalf.

All information provided is treated as strictly confidential and used solely for service delivery purposes. Disability Dream Care adheres to the Australian Privacy Act 1988.

Referral Submitted!

Thank you for your referral. Our team will review it and contact you within one business day to discuss next steps.

What Happens Next?

We review your referral

Our intake team will review all the details provided within one business day.

We contact you

We'll reach out to discuss the participant's needs and confirm service match.

We begin supports

Once agreed, we develop an individual support plan and commence services.

Make a Referral

Referral Form

Referral Submitted!