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Participant Intake Form

At Better Life Care Services, we’ve streamlined our participant intake and referral process to provide a seamless experience for both new and existing clients. Our user-friendly online form is designed to capture all necessary information in one step, making the referral process quicker and more efficient. This system not only accelerates the process but also improves accuracy and ensures privacy, allowing participants to securely submit their details and commence their journey with us without delay.

Client Details

Aboriginal or Torres Strait Islander?
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NDIS Information

Emergency Contact / Guardian Details

Services Required

Support Services Required
Support Services Required (continued)

Funding

If Plan Managed, what is your Plan Managers details:

Upload NDIS Plan

Referrer Details

Additional Information

Additional Comments

Participant/Guradian Declaration

I consent to my information being provided to Better Life Care Services for the purposes of referral, service delivery and inclusion in de-identified data reporting.

We recognise the importance of a smooth transition into our services. That’s why our online form is engineered for speed and precision, ensuring that all information is processed promptly. After submission, our team reviews referrals swiftly, facilitating a quicker response and the prompt initiation of services tailored to each participant's specific needs.

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