Same-day response from our intake team

Refer a participant.

Five short steps, about three minutes. Most fields are optional — answer what you know and our intake team will confirm the rest on the call.

What happens next

1

We receive the referral

Triaged by our NDIS intake team the same business day. Urgent and discharge referrals go to the top of the queue.
2

Intake call

We confirm scope, clinical needs, behaviour support and preferred worker profile, and collect any remaining documents.
3

Service agreement

A plain-language service agreement. Supports, schedule, rates — all visible.
4

First shift & review

First shift scheduled. Participant feedback gathered after two weeks; we adjust.

Need to talk first?

Call our NDIS intake team to talk through a complex referral before submitting.

03 5292 0800

For urgent medical assistance call 000. This form is not monitored as an emergency service.

I am a *

Please specify

Your full name *

OrganisationOptional

Phone *

Email *

Who should we contact about this referral? *

Contact nameOptional

Relationship to participantOptional

Contact phoneOptional

Contact emailOptional

Contact preferencesOptional

Select all that apply. Helps us contact people safely and appropriately.

Step 1 of 5

Only name, suburb, state and plan type are required here. Skip anything you don't have.

Participant first name *

Participant surnameOptional

Date of birthOptional

Helps us assign correctly screened workers.

NDIS numberOptional

Optional at referral stage.

Service suburb *

State *

Where will supports be delivered?Optional

Communication & preferences

Communication needsOptional

Language required

Worker preferencesOptional

We consider preferences but cannot always guarantee them.

NDIS plan & funding

Plan management *

Plan end dateOptional

If known — affects when we can commence.

Plan manager details

Plan manager organisationOptional

Invoicing emailOptional

Plan manager phoneOptional

Has funding been confirmed as available?Optional

Step 2 of 5

Supports required *

Select all that apply.

What other support is needed?

Which high-intensity supports?

These supports require an RN-supervised care plan. Our clinical lead will contact you directly.

Briefly describe the support required *

Schedule

Approximate hours per weekOptional

Shifts per weekOptional

Preferred daysOptional

Shift patternOptional

Drives which staff we can match — worth being accurate here.

Timing

Urgency *

For same-day or after-hours starts, please also call 03 5292 0800 so we can begin matching staff immediately.

Preferred start dateOptional

Reason for referralOptional

Current provider & handover notes

Step 3 of 5

Only the first question is required. Everything else is optional — tell us what you know and we'll cover the rest on the intake call.

Is there an immediate risk of harm, neglect or service breakdown? *

Please describe briefly

Is this referral related to a hospital discharge?Optional

Expected discharge dateOptional

Hospital / treating team contactOptional

Mobility & clinical

Mobility & transfer supportOptional

Allergies, health conditions or clinical risks we should know before contactOptional

Behaviour support

Are there known behaviours of concern?Optional

Brief details

Behaviour support planOptional

Regulated restrictive practicesOptional

Service environment

Anything at the service location our workers should know?Optional

Please provide details

Other supports involved

Who else is involved?Optional

Names, roles and contact details (if known)

Step 4 of 5

Almost done. Documents are optional — only the consent questions below are required.

Supporting documentsOptional

Drop files here, or click to browse

NDIS plan, care plan, BSP, risk assessment, medication chart, discharge summary. PDF, Word or images — max 10 MB each.

Entirely optional — documents can also be sent securely after our intake call.

Review

Participant consent

Consent basis *

We'll accept the referral, but no information will be shared and no service will commence until consent or authority is confirmed. Our intake team will call you to work through this.

The information I've provided is accurate to the best of my knowledge, and I have authority to provide the personal information in this referral. * I understand A Plus Nursing will use this information to assess the referral, contact the relevant people and arrange intake, and that submitting a referral does not guarantee service availability. * Please keep me updated on the outcome of this referral.

Confidentially handled and routed to our NDIS intake team. See our Privacy Policy for how we collect, use and store this information.

Refer a participant.

What happens next

Need to talk first?

Referral received.