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Priority Plus Care is a Registered NDIS Provider Delivering Disability & Aged Care Services | ABN: 95 668 507 864

Referral Form

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How to Submit Referral Form.

Complete the referral form with as much detail as possible so our team can review the participant’s needs, respond promptly, and guide the next steps. Give us a Call on (02) 5836 6637 if you Need Help. 

Share the Participant’s Needs

Include key details about the participant’s situation, support needs, goals, and requested services

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Add Extra Notes for New NDIS Plans

For new NDIS plans, use the Extra Notes section to explain urgency, risks, advocacy needs, or support gaps.

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Submit the Form or Email the PDF

Submit the online referral form or download the PDF form below and email it to our team.

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We Contact You Within 24 Hours

Our team will review the referral and contact you to discuss next steps and suitable support options.

NDIS Referral form

Participant Details
If you prefer us to contact your representative please complete their contact details below.
NDIS Details
Support Coordinator Details
Referral Details
Any Extra Notes
Understanding of Participant
Participant Background Details
Supporting Documents

Our NDIS referral form is available online, however if you would prefer to complete the form offline, please download it using the link below and return the completed form to us by email at info@prioritypluscare.org.au

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