Make a referral

Refer a participant. Start with what matters to them.

With the participant’s permission, share their general support needs and your contact details. We’ll discuss suitability and next steps; a referral does not commit them to services.

For professional partners

Use your own contact details and the participant’s first name. Please leave medical records, plan documents and sensitive histories out of this form.

We’ll discuss goals, service suitability, funding and availability before support is agreed.

info@empowerpathau.com

Please use your contact details and confirm you have permission to refer the participant. Do not include sensitive records.

Organisation (required)

Your role (required)

Participant’s first name (required)

Participant’s suburb or region (required)

Your name (required)

Phone (required)

Email (required)

Support you are looking for

How should we contact you?

How can we help? (required)

I need an interpreter or accessibility support I agree to be contacted about this referral and have permission to share these details. I have read the privacy notice.

Your information is confidential. Please do not share medical records or NDIS plan documents here.