Choose the supports you need, let us know your support preferences

Your referral lets us know what we can do to support you best by telling us how you want to be cared for and if there are important things you want us to know about.

All over Greater Sydney and the Blue Mountains, we have team members that can support you or your loved one.

Need help with your referral?

Send us a message so we can assist you or reach us by email or phone.

Send us a referral

Referral Form v3.4.4.16
  • Select supports
  • Referral details
  • Support profile
  • Confirm referral

Select supports

Let us know which supports are needed

Select as many supports as needed

We offer tailored disability supports and services, which means you can select as many support options as you need, in any combination you want.
We will work with you to make a support plan that suits your needs and preferences.
Contact us if you need any assistance with your referral, you can reach us by email at hello@abstractsupports.com.au or by phone on 0468 857 199.

You can select more supports if needed or continue with the referral when ready.
Contact us if you need any assistance with your referral, you can reach us by email at hello@abstractsupports.com.au or by phone on 0468 857 199.

You can select more supports if needed or choose options for the selected supports below when ready.
Contact us if you need any assistance with your referral, you can reach us by email at hello@abstractsupports.com.au or by phone on 0468 857 199.

Select as many supports as needed
Select as many supports as needed
Select as many supports as needed
Select as many supports as needed

Support funding

Let us know how these supports will be funded

We will discuss these details when we get in touch to confirm the referral.

We currently provide occupational therapy for participants who are NDIA-managed, plan-managed, self-managed or funding out of pocket, other supports are available for plan-managed, self-managed or out of pocket funding only.
Apologies for any inconvenience.

Let us know if the funds are plan or self-managed
Let us know if the funds are plan, self or NDIA-managed
How do you want to provide the plan details?

Personal information consent

By uploading a file to or submitting a form on this website, you agree with and consent to our Website Usage Policy and our Privacy Policy.
These documents outline how we handle your information, these documents are available in full at https://abstractsupports.au/policies.

Confirm you agree with us using the supplied information for the purposes of arranging and providing supports
Has there been an NDIS plan before this one?
Enter the NDIS number

You must agree with our policies before you can upload documents or submit this referral.

You can upload a total of 3 .pdf, .doc, .docx, .png, .gif, .jpg, .jpeg, .jpe, and .xlsx files. Each file must be less than 4mb
Select or enter the NDIS plan start date
Select or enter the NDIS plan end date

Plan management details

Plan manager’s name and contact information

Who is the plan manager?
Choose how we should the plan manager
Enter the plan manager's email address
Enter the plan manager's phone number
You can also give us their email address if you like
You can also give us their phone number if you like

Who is making this referral?

Your name

Participant's details

Your name

Type in your title
Select your title
Enter your first name
Enter your last name

Your contact details

Choose how we should contact you
Enter your email address
Enter your phone number
We will use your email address as an alternative contact method
We will use your phone number as an alternative contact method

Who are these supports for?

Let us know if this referral is for yourself or someone else
Enter how you are related to the participant
What is your relationship to the participant?
Does the participant have a primary contact or nominee?
Tell us if you are the participant's appointed nominee with the agency or if you are acting as their chosen primary contact person
Tell us if the this person is the participant's appointed nominee with the agency or if they are acting as the participant's chosen primary contact
Enter how the nominee is related to the participant
What is the nominee's relationship to the participant?
Let us know if we should contact you or the participant for this referral
Let us know if we should contact you, the nominee or the participant for this referral

We will contact the participant for this referral.

We will contact you for this referral.

We will contact the nominee for this referral.

About the nominee

Nominee's name

Type in the nominee's title
Select the nominee's title
Enter the nominee's first name
Enter the nominee's last name

Nominee's contact details

Choose how we should contact the nominee
Enter the nominee's email address
Enter the nominee's phone number
We will use the email address as an alternative contact method for the nominee
We will use the phone number as an alternative contact method for the nominee

Participant's details

Participant's name

Type in the participant's title
Select the participant's title
Enter the participant's first name
Enter the participant's last name

About the participant

Participant's address

About the participant

Participant's contact details

Choose how we should contact the participant

We will not be able to contact the participant directly if their contact details aren't provided.
Any contact details provided for the participant will be used by us as a last resort contact method.

We will not be able to contact the participant directly.

Choose how we should contact the participant
Enter the participant's email address
Enter the participant's phone number
We will use the email address as a last resort contact method for the participant
We will use the email address as an alternative contact method for the participant
We will use the phone number as an alternative contact method for the participant
We will use the phone number as a last resort contact method for the participant

Your address

Enter your street address
Enter your suburb
Enter your postcode

Participant's address

Enter the participant's street address
Enter the participant's suburb
Enter the participant's postcode

Support profile

Information that helps us support you

Select or enter your date of birth
Enter your gender
Let us know how you identify yourself
Tell us if you want to provide your pronoun
Enter your pronoun
Select your pronoun
Tell us if there are cultural considerations you want us to know about
Describe your background
Tell us if there are other considerations we should know about
Describe your situation or other considerations

Support profile

Information that helps us support the participant

Select or enter the participant's date of birth
Enter the particiapnt's gender
Let us know how the participant identifies themselves
Tell us if you want to provide the participant's pronoun
Enter the participant's pronoun
Select the participant's pronoun
Tell us if there are cultural considerations you want us to know about
Describe the participant's background
Tell us if there are other considerations we should know about
Tell us if there is a legal guardian
Tell us if there is a legal guardian
Describe the participant's situation or other considerations
Describe your communication support needs
Describe the participant's communication support needs
You can upload a total of 3 .pdf, .doc, .docx, .png, .gif, .jpg, .jpeg, .jpe, and .xlsx files. Each file must be less than 4mb
Describe your behaviour support support needs
Describe the participant's behaviour support needs
You can upload a total of 3 .pdf, .doc, .docx, .png, .gif, .jpg, .jpeg, .jpe, and .xlsx files. Each file must be less than 4mb

Emergency contact details

Who is your next of kin or emergency contact?

Tell us who your emergency contact person is
Enter how the emergency contact is related to yourself
What is the emergency contact's relationship to yourself?

Emergency contact's name

Type in the emergency contact's title
Select the emergency contact's title
Enter the emergency contact's first name
Enter the emergency contact's last name

Emergency contact's phone number

Enter the emergency contact's phone number

Emergency contact details

Who is the participant's next of kin or emergency contact?

Tell us who the participant's emergency contact person is
Tell us who the participant's emergency contact person is
Tell us who the participant's emergency contact person is
Tell us who the participant's emergency contact person is
Enter how the emergency contact is related to the participant
What is the emergency contact's relationship to the participant?

Emergency contact's name

Type in the emergency contact's title
Select the emergency contact's title
Enter the emergency contact's first name
Enter the emergency contact's last name

Emergency contact's phone number

We need your phone number if you are the emergency contact

We need the nominee's phone number if they are the emergency contact

Enter the emergency contact's phone number
Enter your phone number
Enter the nominee's phone number

Guardianship details

Legal guardianship arrangements

Enter how the legal guardian is related to yourself
What is the legal guardian's relationship to yourself?
Enter how the legal guardian is related to the participant
What is the legal guardian's relationship to the participant?
Enter any comments about the legal guardianship arrangements
You can upload a total of 3 .pdf, .doc, .docx, .png, .gif, .jpg, .jpeg, .jpe, and .xlsx files. Each file must be less than 4mb

About the legal guardian

Legal guardian's name

Enter the name of legal guardian's organisation
Is the legal guardian an organisation or an individual?
Type in the legal guardian's title
Select the legal guardian's title
Enter the legal guardian's first name
Enter the legal guardian's last name

Legal guardian's contact details

Enter the contact person's first name
Enter the contact person's last name
Choose how we should contact the legal guardian
Enter the legal guardian's email address
Enter the legal guardian's phone number
We will use the email address as an alternative contact method for the legal guardian
We will use the phone number as an alternative contact method for the legal guardian

Support preferences

Your support goals

Support preferences

Participant's support goals

Do you have any goals that you want to work towards with your supports?
Does the participant have any goals that they want to work towards with their supports?

When and where

How often are these supports needed?
We can get these details now or later when we make contact to confirm the referral

Individual support shift

Select or enter the date when the support shift is needed

Minimum shift length is 2 hours.

Select or enter the shift start time
Select or enter the shift end time

The shift will cross midnight and continue into the next day if:

  • You select an end time that is less than 2 hours after .
  • You select an end time that is before .

Selected shift time: - .

Ongoing support days

Select or enter the date when the first support shift is needed

If you know what days these ongoing supports are needed, you can let us know

Minimum shift length is 2 hours.

Select if supports are required on this day
Select or enter the shift start time
Select or enter the shift end time

Day not selected.

The shift will cross midnight and continue into the next day if:

  • You select an end time that is less than 2 hours after .
  • You select an end time that is before .

Monday shift times: - .

Select if supports are required on this day
Select or enter the shift start time
Select or enter the shift end time

Day not selected.

The shift will cross midnight and continue into the next day if:

  • You select an end time that is less than 2 hours after .
  • You select an end time that is before .

Tuesday shift times: - .

Select if supports are required on this day
Select or enter the shift start time
Select or enter the shift end time

Day not selected.

The shift will cross midnight and continue into the next day if:

  • You select an end time that is less than 2 hours after .
  • You select an end time that is before .

Wednesday shift times: - .

Select if supports are required on this day
Select or enter the shift start time
Select or enter the shift end time

Day not selected.

The shift will cross midnight and continue into the next day if:

  • You select an end time that is less than 2 hours after .
  • You select an end time that is before .

Thursday shift times: - .

Select if supports are required on this day
Select or enter the shift start time
Select or enter the shift end time

Day not selected.

The shift will cross midnight and continue into the next day if:

  • You select an end time that is less than 2 hours after .
  • You select an end time that is before .

Friday shift times: - .

Select if supports are required on this day
Select or enter the shift start time
Select or enter the shift end time

Day not selected.

The shift will cross midnight and continue into the next day if:

  • You select an end time that is less than 2 hours after .
  • You select an end time that is before .

Saturday shift times: - .

Select if supports are required on this day
Select or enter the shift start time
Select or enter the shift end time

Day not selected.

The shift will cross midnight and continue into the next day if:

  • You select an end time that is less than 2 hours after .
  • You select an end time that is before .

Sunday shift times: - .

We will discuss these details further when we get in touch to confirm the referral.

Where do you need these supports, or where will we meet you for support shifts?
Where does the participant need these supports, or where will we meet them for support shifts?
Enter the street address
Enter the suburb
Enter the postcode

Support team

Would you like to work with certain workers, or workers who have specific skills, etc…
Would the participant like to work with certain workers, or workers who have specific skills, etc…

Safety checklist

Keeping you and our team safe

Safety checklist

Keeping participants and our team safe

The safety of our clients and team members is our top priority, please answer the following questions so we can look after everyone’s safety as best as possible.

Please answer Yes or No
Please answer Yes or No
Enter details about the risk
Please answer Yes or No
Please answer Yes or No
Enter details about the risk
Please answer Yes or No
Please answer Yes or No
Enter details about the risk
Please answer Yes or No
Enter details about the risk
Please answer Yes or No
Enter details about the risk
Please answer Yes or No
Enter details about the risk
Please answer Yes or No
Enter details about the risk
Please answer Yes or No
Enter details about other known risks

Confirm referral

Additional comments

Before you send your referral, feel free to leave us any other comments or questions below.
We will assist with these comments and questions when we get in touch to confirm the referral.

Enter your comments
Enter your comments
 
 

 

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