Refer a Participant | NDIS Referral Portal | Farrah Disability Services

NDIS Referral Form

All fields marked * are required. Your information is handled securely.

1. Your Details (Referrer)

Full Name *

Role / Title *

Organisation *

Phone Number *

Email Address *

2. Participant Details

First Name *

Last Name *

Age *

Suburb / Postcode *

NDIS Number (optional)

3. Support Required

Daily Living Transport Community Access Life Skill Development Support Coordination Household Tasks ✦ Elevate Youth Program (Ages 14–25)

4. Plan Details

Plan Management *

Urgency Level *

5. Additional Information

Support Needs & Goals (optional)

Best Time to Contact You

By submitting this form you confirm you have consent to share this participant's information. We'll respond within 48 business hours.

03 7051 2280 0481 178 257

info@farrahdisabilityservices.com

215 Bell St, Preston VIC 3072

We review your referral

Within 48 hours, our intake team reviews the referral details.

We contact you

We'll call or email to discuss the participant's needs and confirm fit.

Participant onboarding

We arrange a meet-and-greet and sign the service agreement.