Referral Information

Make a Referral

Thank you for choosing Your Positive Path.
This referral form allows you to submit details securely so we can understand the individual’s needs and determine the most appropriate mental health and NDIS support services.

If you have questions before submitting a referral or would like guidance around our services, eligibility, or funding options, you are welcome to contact us. We are here to support you through the process.

Who Can Submit a Referral

Referrals are welcome from:
  • NDIS participants
  • Family members and carers
  • Support coordinators and case managers
  • Healthcare professionals and referrers

This referral form helps us ensure timely and appropriate mental health and disability support for each individual.

Please complete the form with as much information as possible. Once submitted, our team will carefully review the referral and contact you to discuss availability, suitability, and next steps.

Client Details

Referrer Details

(Person making the referral)

Health Care Information

NDIS Details

Appointment & Consent

Please provide contact details for appointments, emergencies, and confirm consent.

Nominee Contact Details (if applicable)

Emergency Contact

Who should we contact in case of an emergency?

Consent

All information shared through this referral form is treated with strict confidentiality. We are committed to protecting personal and sensitive information in line with privacy and ethical practice standards.

Accessible Support Options

What Happens After You Submit the Referral

Once the referral is received:
  • Our team reviews the information confidentially
  • We assess service suitability and availability
  • We contact you or the participant to discuss next steps
  • We provide guidance around appointments, funding, and service options

Our goal is to make the referral and intake process clear, respectful, and supportive.

Still have questions?

Need Help Before Submitting a Referral?

If you are unsure whether our services are suitable or need help completing the referral form, we encourage you to get in touch. Our team can assist with:

  • Understanding our mental health and NDIS services
  • Clarifying eligibility or funding options
  • Answering questions about the referral process

If you are unsure whether our services are suitable or need help completing the referral form, we encourage you to get in touch. Our team can assist with:

Contact us via our Contact page or email admin@yourpositivepath.com.au