Refer a Participant – Independent Living Options

Referrers Details

Name *

Email *

Phone

What Services are you interested in?

Participant Details

Name of the Participant *

Name of the Guardian

Date of Birth *

Address

Address Line 1

City

State / Province / Region

Postal Code

Gender

Male
Female
Other

NDIS Participant No.

NDIS Plan Date *

Fund Management *

What is the Participants disability?

Reason for Referral

NDIS Pricing Arrangements and Price Limits and Support Catalogue: All our prices are in accordance with the current NDIS Pricing Arrangements and Price Limits document and NDIS Support Catalogue for applicable services. If any of our prices are inconsistent with prices in the NDIS Pricing Arrangements and Price Limits, then the prices in the NDIS Pricing Arrangements and Price Limits, will apply.

Our prices will increase from time to time in line with NDIS maximums.

GST: Most of our prices do not include GST unless provided for in the NDIS Pricing Arrangements and Price Limits. If GST is included, it will be included in the price given to you.

Additional expenses: These are not included as part of a Participant’s NDIS Supports such as stationery, printing costs, internet connection (unless provided complimentary), etc. These are the responsibility of the Participant and/or the Participant’s Representative and are not included in the cost of the Supports.