Make a Referral

Refer yourself, a family member, or a client to Safe Hands Disability. Our intake team will contact you within 1 business day to discuss your needs.

1

Submit Referral

Complete the form below — takes about 5 minutes

2

We Call You

Our intake team contacts you within 1 business day

3

Needs Assessment

We discuss goals, plan details, and available supports

4

Service Agreement

We prepare your service agreement and match your workers

5

Supports Begin

Your supports start — usually within 1–2 weeks of referral

No NDIS plan yet? That's okay — you can still submit a referral. We can help you understand your options and connect you with local support while you work through the NDIS access process.

1. Who Is Making This Referral?

2. Participant Details

Optional but helps us send you your service agreement
We use this to confirm we service your area and match local workers

3. NDIS & Plan Details

9-digit number on your NDIS correspondence

4. What Support Is Needed?

Select all that apply:

Plain language is fine — just tell us what you're hoping to achieve

5. Disability & Health Information

This information is confidential. It is used only to match you with workers who have the right skills and experience. You are not required to share a diagnosis — describe your support needs in whatever way feels right for you.

6. Worker Preferences

7. Urgency & Availability

8. Anything Else We Should Know?

9. Consent & Declaration

Your information is encrypted and stored securely. Safe Hands Disability will never sell or share your personal information with third parties without your explicit consent. Fields marked * are required.

Referral Received — Thank You!

We've received your referral and a member of our intake team will contact you within 1 business day to discuss next steps. If you haven't heard from us by then, please call us on 0466 441 662.

While you wait, you might find these pages helpful:

What Is the NDIS?  |  NDIS Funding Guide  |  Contact Us

Not Ready to Refer Yet?

That's fine — explore our services, read about the NDIS, or come to a free information event. We're here whenever you're ready.

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