Make a referral

Let's get started.

Participants, families, support coordinators and health professionals can all refer. You do not need anyone's permission, and there is no cost to enquire.

One business day

Every referral gets a real response within one business day, usually the same afternoon.

A conversation, not a form letter

We will call and talk it through properly before anything is proposed.

No obligation

Nothing is committed until you have met a worker and read a service agreement.

Referral form

Tell us what is needed.

About five minutes. Fields marked with an asterisk are required, and you can leave the rest blank if you do not know yet.

Progress 0% complete

Who is making this referral?

Your relationship to the participant

Your name

Your phone

Your email

Organisation (optional)

If you are referring in a professional capacity.

How would you rather we got back to you?

A phone call Email A text message

About the participant

If you are referring yourself, this is you. Only the name and suburb are required at this stage.

Participant's name

Date of birth (optional)

Helps us match an age-appropriate worker.

Suburb

Where support would be delivered.

Postcode (optional)

Participant's phone (optional)

Participant's email (optional)

Access and communication needs (optional)

Anything we should know so our first contact works well. For example: Easy Read, an interpreter, no phone calls, a preferred name, or a support person who should be included.

Interpreter required? (optional)

We arrange interpreters free of charge through TIS National.

Their NDIS plan

Do not worry if you cannot answer all of this. We can work it out together on the phone.

NDIS number (optional)

Plan end date (optional)

How is the plan managed? (optional)

Upload the NDIS plan (optional)

Attaching the plan saves a round of questions and lets us quote accurately. A plan is sensitive health information, so it is emailed straight to our office and stored nowhere else. Up to 4MB in total: if yours is larger, email it to info@hopeharbour.com.au and we will match it to this referral. You can also skip this entirely.

What support is needed?

Which supports are you enquiring about?

Tick as many as apply.

In-home support Personal care, daily living, household tasks Social & community participation Getting out, activities, travel training Supported accommodation (SIL) Supported Independent Living in a shared home Respite and short stays Short Term or Medium Term Accommodation Not sure yet Tell us what a hard week looks like and we will work it out with you

Roughly how many hours a week? (optional)

When would you like to start? (optional)

Goals, support needs and anything else we should know (optional)

The most useful thing you can write here is what a hard day looks like, and what a good one would look like instead. Include any behaviour support plan, complex health needs, manual handling requirements or risks we should be aware of.

Consent

The participant (or their decision-maker) has agreed to this referral We cannot act on a referral without this. It is a requirement of the NDIS Code of Conduct, not just our policy. See our privacy policy for how we handle this information.

We respond to every referral within one business day, usually the same afternoon.

Rather not fill in a form?

Completely fine. Ring us and we will take the details over the phone, or email whatever you have.

Call 0414 851 688 Email us

Support coordinators: you are welcome to email a referral pack or NDIS plan extract straight to info@hopeharbour.com.au.

What happens next

We confirm

An email straight away so you know it arrived.
We call

Within one business day, to talk it through.
We meet

At home, on the phone or over video. Free, no obligation.
You meet a worker

Before anything is signed.

Your privacy

This form emails your details to our office and nowhere else. We do not sell or share them, and we delete enquiries that do not proceed after 12 months. Read the privacy policy.