Make a Referral

At Jewel Australia Support Services, we welcome referrals for individuals seeking reliable, person-centred NDIS support. This referral form allows participants, families, support coordinators, and other stakeholders to refer someone who may benefit from our services.

All referrals are reviewed promptly, and our team will make contact to discuss support needs, goals, and next steps. Information provided through this form is treated confidentially and in line with privacy and NDIS requirements.

Please complete the form below, and a member of our team will be in touch.

Name
Reason For Referral
Please provide any additional information you feel will be useful e.g., level of mobility, communication skills, effectiveness of continence products
Service Requested
Management plan attached
This referral has been discussed with the NDIS Participant/ Participants legal representative
Indigenous Status
Is the Participant under 18 or subject to a legal order?
For example State-based Care and Protection Order, Guardianship Order etc
Name of person completing the referral

About Us

At Jewel Australian Support Services, we are dedicated to delivering exceptional healthcare with compassion, innovation, and integrity. For over 16 years, we have been a offering comprehensive medical services in Australia

Contact Info

10 Chirnside Cct,
Kambah ACT 2902, Australia

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