Referral Application Form – Relief Wakes
NDIS Provider No. 4053361903

Referral Application Form

Help someone you care about access the support they need. Complete this referral form and we'll reach out to get them started on their journey.

1
Fill in the form
2
We review within 24–48hrs
3
We contact the participant
4
Support begins
500+
Clients Supported
13
NDIS Support Classes
24–48hr
Response Time
24/7
Support Available
Relief Wakes Team – Referral Support
How It Works

What Happens After You Submit

Our team works quickly to ensure every referral is handled with care and professionalism.

1

Submit the Form

Complete all fields in the referral form with accurate participant and referrer details.

2

We Review

Our intake team reviews your referral within 24–48 business hours and assesses the support needs.

3

We Make Contact

We reach out to the participant and/or referrer to confirm details and discuss the next steps.

4

Support Begins

Once confirmed, we match the participant with the right support worker and begin delivering services.

📋 Submit a Referral

Please complete all required fields. The information you provide helps us deliver the right support to the right person quickly and safely.

    Privacy Policy

    🔒 Your information is protected under our Privacy Policy and the Australian Privacy Act 1988. We will never share your details without consent.

    Need Help Before Submitting?

    Our friendly team is happy to walk you through the referral process. Call us or send a message and we'll guide you every step of the way.

    📞 Call Us Now Send a Message