NDIS REFERRAL

The Team at Paragon PsychConnect provide a comprehensive assessment and treatment service for people eligible for NDIS services if you are self-managed or plan managed.

Please complete the form below and we will contact you to discuss your client's needs.

Once you complete the form and press “Submit Referral Form”, the form will be sent to us and emailed to you as an attachment.

Alternatively, you can call our Admin Manager, on 0412 565 923.

If you cannot complete the online form below, please go to Referral Forms to download a pdf form that you can fill in, and either email it to us or bring it with you, to assist us with your initial appointment.

 
Referral Form NDIS
  • Client Details
  • Referrer Details
  • Plan Funding Details
  • Referral Details
  • Referral Details
  • Submit Form

Client Details

Client Title
Client Address *
Client Address
Is an Interpreter Required?