Make a Referral

You can make a referral to our first-class therapy team by completing this online form. After we have received your referral, we will be in touch within three (3) business days with more information.

Upon submitting this referral, you will receive a ‘thankyou’ message. If you do not receive this, the form has not been submitted. You will need to fix the incomplete information and hit submit again.

Please note, this is a comprehensive referral form. If you would prefer to make a simple enquiry, please visit our Contact Us page.

The Ability Lab Online Referral Form

Client Details

First Name

Last Name

Date of Birth

Phone

Address

NDIS No.

(If not an NDIS participant, write N/A)

NDIS Plan Dates

(If not an NDIS participant, write N/A)

Service/s Required

Speech Pathology

Occupational Therapy

Psychology

Referral Information (including disability type and goals for therapy)

Referrer Details

First Name

Last Name

Phone

Organisation (if applicable)

Relationship to Client

Do you have consent from the client or their person responsible to share the information on this form and make this referral?

Person Responsible Details (if relevant and different from above)

First Name

Last Name

Phone

Relationship to Client

Funding Information

Funding Management

Plan Management Organisation (if applicable)

Contact Name for Invoices

Email for Invoices

How did you hear about us?