Therapy Services Referral Form

We strive to meet the needs of our clients by offering quality services by qualified and well supported therapists.

You can check to see if we have availability for the services you would like to book in your particular area before completing this online referral form. Or you can call our Customer Service team on 1300 004 414 if you have any questions about wait times.

Please note:

  • When you have completed and submitted the form correctly, you will receive a notification email. If you do not receive a notification email (check your junk emails) then we do not have a copy of your referral.
  • When you click on submit you will receive this message at the top of the page: ‘Thank you very much for your referral. Someone from our intake team will be in contact with you shortly.’
  • If you click on submit and do not receive the thank you message, the form has not been submitted.  You will need to scroll to the top of the form to see what the error message is saying.
  • Any fields where information is required that hasn’t been included when you hit SUBMIT, will display with a red box around them. Please complete these red fields and hit submit again.