Referral Form for NDIS Support

Thank you for choosing Empowered Community Services.

Support is just around the corner! We’ve made it even easier for you to fill out our referral form. Once our team receives your referral form, we will be in touch within 3 business days. From there, we will look to schedule a meeting to discuss your NDIS support needs and assess how we can best support you in achieving your goals. Let’s make this support happen!

"*" indicates required fields

Participant Details
MM slash DD slash YYYY
MM slash DD slash YYYY
MM slash DD slash YYYY
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?*
Max. file size: 516 MB.
Referral Completed By
How did you hear about us?*
Max. file size: 516 MB.
This field is for validation purposes and should be left unchanged.

TESTIMONIALS

Discover the inspiring testimonials from Participants and stakeholders, as well as their experiences and the positive impact of our services. Hear the heartfelt stories and learn how Empowered Community Services is making a real difference in their lives.

"My life was blessed in 2020 as a support worker, I was invited to join the team with Empowered Community Services."
empowered community services
“The support I receive from Empowered is simply exceptional. Friendly, professional, and understanding, and I feel they go above and beyond. I highly recommend them!”
empowered community services
"Empowered Community Services has completely changed my perspective and life quality. All of the staff go above and beyond the standard of care and genuine support..."
"Quality NDIS provider."
"The fact that staff here understand what masking is gives my autistic soul such comfort..."
Read more reviews

Our referral form is designed to gather all the essential information we need to start your journey with us. Empowered Community Services is committed to providing high-quality support that is centred around your needs and goals. By filling out this form, you are taking the first step towards receiving amazing NDIS support.

 

If you would like to know more about how Empowered Community Services started, visit the link below.

Learn Our Story

Get to know us better! Discover our journey and values.

ABOUT US

Born from intimate family experiences with disability, Empowered Community Services stands unique. Our team, rich in Support Worker experience, channels this insight into compassionate and effective support for our community

Sign up to our newsletter

Skip to content