Make a referral

Families and professionals are both welcome to refer. Fill in the form below and our team will be in touch within 24–48 hours. There's no need for a formal referral letter to get started — though if you're a GP arranging Medicare rebates, a CDM plan helps.

Client details

First name * Please enter the child's first name.

Last name * Please enter the child's last name.

Date of birth

Address or suburb

Funding

NDIS Self-Managed NDIS Plan-Managed Medicare Private

Referrer details

Full name * Please enter your name.

Contact phone * Please enter a contact phone number.

Contact email * Please enter a valid email address.

Relationship to client

Reason for referral

Reason for referral (required) Please share a little about why you're referring.

Your details are emailed securely to our team. We reply within 24–48 hours.

Sorry — something went wrong sending your referral. Please email [email protected] or call 0424 136 275.

Referral received — thank you

We've got the details and will be in touch within 24–48 hours. If it's urgent, please call us on 0424 136 275.