We welcome your referral for our community-based adult neuro services of Occupational Therapy, Physiotherapy and Speech Pathology. Our friendly and helpful referral team are always happy to discuss you or your client’s allied health intervention needs.

Simply complete our online referral form below and we will contact you within 5 business days to complete the process.

You may be interested in viewing our referral information, current availability, service areas, and information on NDIS or privately funded clients depending on funding circumstances.

If you require assistance with your referral, please call our intake team between 8:30am and 5pm (Melbourne time) on  (03) 9885 2533.

Referral Form

Please complete the form below and note compulsory fields are marked with a red asterisk.
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Client Details

Please provide information about the person you are referring for our services.

Client Name
Client Address
Next of Kin / Alternative Contact
Next of Kin / Alternative Contact Name

Referrer Details

Who should we contact regarding this referral?

Referrer Name
Referrer Email

Referral Information

Please provide details about the services you require.

Which services are you referring for?

Please note as we are a community based neurological rehabilitation service, we are not able to accept referrals where the primary diagnosis is any of the following: Intellectual Disability, Autism Spectrum Disorder, or Psychosocial.

Funding

Please provide information about how the client's services will be funded.

Funding Body
Who should we email invoices to?
Name

Risk

Are there any behavioural or other risks we should know about?

Other Information

Click or drag files to this area to upload. You can upload up to 5 files.
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Related information

Learn more about our Occupational Therapy, Physiotherapy and Speech Pathology services. Find out more about us and meet our team. Contact us to enquire about our services.  Back to top