Make a Referral
Participants, families, nominees, support coordinators and other referrers can use this short form to tell us what support is needed and when.
What Happens After You Submit
A referral starts a conversation. It does not confirm acceptance or service availability.
Short Referral
Provide contact details, relationship or authority, participant first name, suburb, service interest and preferred day or time.
Initial Review
We review the request, location and current capacity. We aim to respond within two business days.
Consent & Suitability
Before discussing participant information, we confirm consent or other authority and whether Relief Wakes may be suitable.
Secure Onboarding
If the referral can proceed, necessary documents and risk information are collected later through an appropriate intake process.
📋 Submit a Short Referral
Only the minimum first-contact details are requested here. Required onboarding information is collected later if the referral can proceed.
Refer a participant securely
The referral form works on iPhone, Android or computer and does not require sign-in. Please provide only the minimum information needed for first contact.
Open participant referral formSubmitting a referral does not confirm services. We aim to respond within two business days.
Need Help Before Submitting?
Call, text or send a short enquiry and we will explain the next step.
