Get in Touch

Contact Guiding Connections

Send a general enquiry, or submit a participant referral. We respond to all enquiries promptly.

Send an Enquiry Submit a Referral

Email Us

admin@guidingconnections.com.au

Location

Adelaide, South Australia

Enquiries

Received 24/7, responded promptly

Participant Referral Form

For health professionals, support workers, allied health providers, planners or family members referring a participant for NDIS Support Coordination services. All referrals are treated with strict confidentiality.

Who can make a referral?

Referrals are welcome from anyone involved in a participant's care or life — professionals and family members alike.

Allied Health Professionals

Occupational therapists, psychologists, social workers, physiotherapists and others.

NDIS Planners & LACs

Local Area Coordinators and NDIS planning delegates connecting participants with coordination support.

Family Members & Carers

Parents, guardians or informal carers acting on behalf of a participant.

Support Workers & Providers

Existing service providers who identify a participant's need for coordination support.

Consent Note

By submitting this form, you confirm that you have the participant's consent to share their information with Guiding Connections for the purpose of assessing service suitability.

Referral Details

Step 1 of 6 — Personal Details

Personal

NDIS Plan

Disability

Contacts

Medical

Goals

Participant Personal Details

First Name *

Last Name *

Date of Birth *

Gender

Phone Number *

Email Address

Street Name *

Start typing to search. Suburb, state, and postcode will auto-fill.

Street No. *

Preferred Contact Method

Primary Language Spoken at Home

Is an interpreter required?

Yes No

Contacts

Emergency Contacts *

At least one emergency contact is required

Contact #1

Full Name *

Relationship to Participant *

Phone *

Lives with participant?

Yes No

Other Contacts

NDIS nominees, parents, carers, case managers and other important contacts

No additional contacts added yet.

Medical & Current Supports

GP / General Practitioner

Known Medical Conditions / Health Alerts

Current Medications (stored securely, shared only with consent)

Allied Health Providers Currently Engaged

OT, Physio, Speech, Psychologist, Dietitian etc.

No allied health providers added yet.

Current NDIS Service Providers

Daily living, community, transport, etc.

No NDIS providers added yet.

Known Gaps in Current Support

Allied Health Providers to Engage

Practitioners that still need to be sourced or engaged

No practitioners to engage added yet.

Has the participant had a previous Support Coordinator?

Yes No

Goals, Referral Details & Consent

Participant Goals

Short-term Goals

Long-term Goals

Focus Areas (select all that apply)

Housing Employment Education Community Participation Independent Living Health & Wellbeing

Your Details (Referrer)

Your Full Name *

Organisation / Role

Your Phone *

Your Email *

Your Relationship to Participant *

Urgency *

Service Requested *

How did the participant / referrer hear about us?

Additional Notes / Context

I confirm that the participant (or their legal guardian/nominee) has given consent for their information to be shared with Guiding Connections for the purpose of assessing service suitability. *

I acknowledge that the information provided will be handled in accordance with the Australian Privacy Act 1988 and Guiding Connections' privacy policy. *

General Enquiry

Direct Access to Support

Have questions about your NDIS plan or want to know more about our services? We are here to help. Fill out the form and we'll be in touch.

admin@guidingconnections.com.au

Adelaide, South Australia

Enquiries received 24/7

Submitted a referral?

If you've already submitted a participant referral above, thank you! We'll review it and be in touch shortly.

Contact Guiding Connections

Referral Submitted

Participant Referral Form

Who can make a referral?

Referral Details

Participant Personal Details

NDIS Plan Details

Disability & Support Needs

Contacts

Medical & Current Supports

Goals, Referral Details & Consent

General Enquiry

Direct Access to Support

Send an Enquiry