Make a Referral | The Daily Doing

No GP Referral Required

We welcome referrals from anyone — family members, carers, support coordinators, health professionals, or the individual themselves. We accept NDIS, TAC, WorkSafe, My Aged Care, Chronic Disease Management plans and private funding.

Participant Information

First Name *

Last Name *

Date of Birth

Phone Number *

Email Address A confirmation will be sent here if provided

Residential Address

Disability / Condition

Relevant Medical History

Reason for Referral *

Support Person / Next of Kin

Please provide details of a support person or next of kin where applicable.

Name

Relationship to Client

Phone Number

Funding Information

Funding Body *

Allocated OT Hours (if known)

Referrer Information

Referrer Name *

Relationship to Client *

Referrer Phone *

Referrer Email

Risk Assessment

Our therapist may be visiting the home environment. Please select any of the following that may apply to the participant or any household members — this helps us to prepare and ensure a safe visit.

Aggressive or challenging behaviour Drug or alcohol use in the household Weapons present in the household Dogs or animals that may pose a risk Infectious disease or contamination risk Hoarding or cluttered environment Smoking in the property Family violence concerns Other (please specify below)

Additional Information

Any further information important to note e.g. interpreter required, preferred contact times, access requirements