The right support starts with the right information.

Start with the person making this referral.

The participant should know about this referral. Only share information you are authorised to provide.

Please enter each detail in its own field. Optional details can be discussed with our team.

Let us know who to contact first. Add their email address or phone number, or both.

Enter the address where support is requested. We work across the Hunter and Central Coast.

You decide who is involved in conversations about support. This section is optional.

Tell us how to make conversations comfortable and accessible.

Describe the services you are interested in. We will talk through suitability and capacity.

The participant’s priorities are the starting point.

These details help us discuss whether the proposed support can work.

Keep this brief. Please do not upload or paste medical records. Detailed support information can be discussed securely with the team.

Share practical access or safety considerations, without including private records. This form is not monitored for emergency assistance.

Add the details you have available. If a plan is being renewed or you are unsure, leave the relevant fields blank and let us know below.

Let us know about the coordinator or service you want involved. Only share another person’s details with permission.

Before you review, add anything else that would help us start the conversation.

Check the information below. You can go back to make changes before downloading or sending your referral.