Referral
(02) 4054 9286
Question 1
Are you aged between 7 and 65?
Yes. Go to the next question.

No. I have a child aged under 7. Find out more about Help for children under 7.

No. I'm over 65. You must be under 65 to access the NDIS. You may be able to access other supports. Find out about NDIS and Aged Care.
Question 1
Question 2
Do you live in Australia and have Australian residency?
Yes. I live in Australia and I am an Australian citizen or have a Permanent or Special Category Visa. Go to the next question.

No. You may be able to access other supports.The NDIS is only available to:
  • People who live in Australia
  • Australian citizens
  • Permanent Visa holders
  • Protected Special Category Visa holders.
    • Question 2
    Question 3
    Do you usually need support from a person because of a permanent and significant disability?
    Yes. You may be eligible. Find out how to apply.

    No. Go to the next question.
    Question 3
    Question 4
    Do you use special equipment because of a permanent and significant disability?
    Yes. You may be eligible. Find out how to apply.

    No. Go to the next question.
    Question 4
    Question 5
    Do you need some supports now to reduce your future needs?
    Yes. You may be eligible. Find out how to apply.

    No. The NDIS may not be the best way to support you. You may be able to access other supports.
    Question 5

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    Mental Health Statement of Coorporation

    © Copyright 2020 Empowered Community Services | Terms and Conditions

    Empowered Community Services Pty Ltd
    ACN: 634 541 076 | NDIS Provider Number: 4050060444

    Current Capacity

    WE HAVE CAPACITY !

    Community Access & Capacity Building

    0 Hours

    Support Coordination

    0 Participants

    Specialist Support Coordination

    0 Participants

    School Leavers Employment Program

    0 Participants
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    Referral Form

    Referral Form

    Participant Details

    Gender *
    Does the participant identify as Aboriginal or Torres Strait Islander? *

    Participant Information

    Services Requested by the Participant
    Are there any known safety concerns or potential risks that we should be aware of before proceeding with support for the Participant?
    Maximum upload size: 516MB

    Referral Completed By

    How did you hear about us? *
    Upload additional information such as participants NDIS plan
    Maximum upload size: 516MB

    Team Leaders

    Participants receiving Community Access and Capacity Building Supports will be assigned a Team Leader. Our Team Leaders can help with tracking participant goals, developing strategies to assist with support, communicating strategies with staff, and developing reports progress reports. Team Leaders will be charged under the Non-face-to-face line item as necessary.

    Establishment Fee

    Participants with more than 20 hours of support per month may be charged an establishment fee when entering the service.