Request support – Abstract Supports

Do you or a loved one want support with goals or daily activities?

We would love to assist!

Choose the supports you need, let us know your support preferences

Your referral lets us know what we can do to support you best by telling us how you want to be cared for and if there are important things you want us to know about.

All over Greater Sydney and the Blue Mountains, we have team members that can support you or your loved one.

Need help with your referral?

Send us a message so we can assist you or reach us by email or phone.

Send us a referral

Referral Form v3.4.5.0

Select supports
Referral details
Support profile
Confirm referral

Select supports

Let us know which supports are needed

What type of supports are needed?

In-home and everyday supports

Community and social access

Respite and holiday services

Mental health supports

Nursing, therapies and allied health

Personal care

Select as many supports as needed

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We offer tailored disability supports and services, which means you can select as many support options as you need, in any combination you want.
We will work with you to make a support plan that suits your needs and preferences.
Contact us if you need any assistance with your referral, you can reach us by email at hello@abstractsupports.com.au or by phone on 0468 857 199.

You can select more supports if needed or continue with the referral when ready.
Contact us if you need any assistance with your referral, you can reach us by email at hello@abstractsupports.com.au or by phone on 0468 857 199.

You can select more supports if needed or choose options for the selected supports below when ready.
Contact us if you need any assistance with your referral, you can reach us by email at hello@abstractsupports.com.au or by phone on 0468 857 199.

In-home and everyday supports

Cleaning services

Support workers and general daily care

Meal preparation assistance

Post hospital care

Companionship care

Personal care

Life coaching supports

Mental health support workers

Help with studies or other personal administration

Select as many supports as needed

Community and social access

Attending appointments

Shopping assistance

Accessing community activities

Accessing social events

Accessing studies or work

Companionship care

Mental health support workers

Select as many supports as needed

Mental health supports

Mental health clinicians

Mental health support workers

Mental health nursing

Mental health getaways and respite

Post hospital care

Companionship care

Select as many supports as needed

Nursing, therapies and allied health

Occupational therapy

Mental health clinicians

Post hospital care

Clinical nursing

Registered nursing

Mental health nursing

Select as many supports as needed

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Support funding

How are these supports funded?

Use an NDIS plan for support funding

Supports will be funded out of pocket

Let us know how these supports will be funded

We will discuss these details when we get in touch to confirm the referral.

We currently provide occupational therapy for participants who are NDIA-managed, plan-managed, self-managed or funding out of pocket, other supports are available for plan-managed, self-managed or out of pocket funding only.
Apologies for any inconvenience.

How are the NDIS funds managed?

Plan-managed, invoices are paid by a plan manager

Self-managed, invoices are paid upfront by the participant who then claims reimbursement from the NDIA

Let us know if the funds are plan or self-managed

How are the NDIS funds managed?

Plan-managed, invoices are paid by a plan manager

Self-managed, invoices are paid upfront by the participant who then claims reimbursement from the NDIA

NDIA-managed, payment bookings are made directly with the NDIA by the provider

Let us know if the funds are plan, self or NDIA-managed

Provide plan details

I want to upload the NDIS plan

I will enter the plan information

How do you want to provide the plan details?

Personal information consent

By uploading a file to or submitting a form on this website, you agree with and consent to our Website Usage Policy and our Privacy Policy.
These documents outline how we handle your information, these documents are available in full at https://abstractsupports.au/policies.

* I consent for Abstract Supports to store a copy of the information and documents provided in this referral and to use this information for the purposes of arranging necessary supports, this includes sharing information with other parties who are involved in providing those supports, are a part of the participant's support network or in other cases where required by law in accordance with our relevant policies. I confirm that I have authority to give this consent for this information.

Confirm you agree with us using the supplied information for the purposes of arranging and providing supports

First NDIS plan

This is the first NDIS plan

Has there been an NDIS plan before this one?

NDIS number

Enter the NDIS number

You must agree with our policies before you can upload documents or submit this referral.

Upload NDIS plan

Select files

You can upload a total of 3 .pdf, .doc, .docx, .png, .gif, .jpg, .jpeg, .jpe, and .xlsx files. Each file must be less than 4mb

Plan start date

Select or enter the NDIS plan start date

Plan end date

Select or enter the NDIS plan end date

Plan management details

Plan manager’s name and contact information

Plan manager name

Who is the plan manager?

Plan manager contact method

I have their email address

I have their phone number

Choose how we should the plan manager

Email address

Enter the plan manager's email address

Phone number

Enter the plan manager's phone number

Email address

You can also give us their email address if you like

Phone number

You can also give us their phone number if you like

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Who is making this referral?

Your name

Participant's details

Your name

Enter title

Type in your title

Referrer title

Select your title

First name

Enter your first name

Middle name

Last name

Enter your last name

Your contact details

Your preferred contact method

I want an email reply

I want a phone call

Choose how we should contact you

Email address

Enter your email address

Phone number

Enter your phone number

Email address

We will use your email address as an alternative contact method

Phone number

We will use your phone number as an alternative contact method

Who are these supports for?

Who is this referral for?

This referral is for myself

This referral is for someone else

Let us know if this referral is for yourself or someone else

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Enter relationship

Enter how you are related to the participant

Relationship to participant

What is your relationship to the participant?

Participant's nominee or primary contact

The participant does not have a nominee or primary contact

I am the primary contact or nominee

Someone else is the primary contact or nominee

Does the participant have a primary contact or nominee?

Has the participant appointed you as their nominee with the agency?

I have been appointed as nominee

I am the chosen primary contact

Tell us if you are the participant's appointed nominee with the agency or if you are acting as their chosen primary contact person

Has the participant appointed the nominee with the agency?

The nominee is appointed

The nominated person is the chosen primary contact

Tell us if the this person is the participant's appointed nominee with the agency or if they are acting as the participant's chosen primary contact

Enter relationship

Enter how the nominee is related to the participant

Relationship to participant

What is the nominee's relationship to the participant?

Who should we contact for this referral?

Contact the participant

Contact me

Let us know if we should contact you or the participant for this referral

Who should we contact for this referral?

Contact the participant

Contact me

Contact the nominee

Let us know if we should contact you, the nominee or the participant for this referral

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We will contact the participant for this referral.

We will contact you for this referral.

We will contact the nominee for this referral.

About the nominee

Nominee's name

Enter title

Type in the nominee's title

Title

Select the nominee's title

First name

Enter the nominee's first name

Middle name

Last name

Enter the nominee's last name

Nominee's contact details

Nominee's preferred contact method

They want an email reply

They want a phone call

Choose how we should contact the nominee

Email address

Enter the nominee's email address

Phone number

Enter the nominee's phone number

Email address

We will use the email address as an alternative contact method for the nominee

Phone number

We will use the phone number as an alternative contact method for the nominee

Participant's details

Participant's name

Enter title

Type in the participant's title

Title

Select the participant's title

First name

Enter the participant's first name

Middle name

Last name

Enter the participant's last name

About the participant

Participant's address

About the participant

Participant's contact details

Participant's preferred contact method

They want an email reply

They want a phone call

The participant doesn't want direct contact

They don't have a phone number or email address

Choose how we should contact the participant

We will not be able to contact the participant directly if their contact details aren't provided.
Any contact details provided for the participant will be used by us as a last resort contact method.

We will not be able to contact the participant directly.

Participant's preferred contact method

They want an email reply

They want a phone call

Choose how we should contact the participant

Email address

Enter the participant's email address

Phone number

Enter the participant's phone number

Email address

We will use the email address as a last resort contact method for the participant

Email address

We will use the email address as an alternative contact method for the participant

Phone number

We will use the phone number as an alternative contact method for the participant

Phone number

We will use the phone number as a last resort contact method for the participant

Your address

Street address Line 1

Street address Line 2

Enter your street address

Suburb

Enter your suburb

Postcode

Enter your postcode

State

Country

Participant's address

Street address Line 1

Street address Line 2

Enter the participant's street address

Suburb

Enter the participant's suburb

Postcode

Enter the participant's postcode

State

Country

Support profile

Information that helps us support you

Your date of birth

Select or enter your date of birth

Enter gender

Enter your gender

Gender

Let us know how you identify yourself

Provide pronoun

I want to provide my pronoun

Tell us if you want to provide your pronoun

Enter pronoun

Enter your pronoun

Select pronoun

Select your pronoun

Cultural identity and background

I am of Aboriginal and/or Torres Strait Islander origin

I have a culturally and linguistically diverse background (CALD)

I want to describe my background...

Tell us if there are cultural considerations you want us to know about

Your background

Describe your background

Other considerations

I require interpreters or communication supports

I have a behaviour management plan or other behaviour supports

I have a legal guardian or someone who makes my legal decisions for me

I want to describe my situation...

Tell us if there are other considerations we should know about

Your circumstances

Describe your situation or other considerations

Support profile

Information that helps us support the participant

Participant's date of birth

Select or enter the participant's date of birth

Enter gender

Enter the particiapnt's gender

Gender

Let us know how the participant identifies themselves

Provide pronoun

I want to provide the participant's pronoun

Tell us if you want to provide the participant's pronoun

Enter pronoun

Enter the participant's pronoun

Select pronoun

Select the participant's pronoun

Cultural identity and background

The participant is of Aboriginal and/or Torres Strait Islander origin

The participant has a culturally and linguistically diverse background (CALD)

I want to describe the participant's background...

Tell us if there are cultural considerations you want us to know about

Participant's background

Describe the participant's background

Other considerations

The participant requires interpreters or communication supports

The participant has a behaviour management plan or other behaviour supports

The participant has a legal guardian or is not legally responsible for their decision making

I want to describe the participant's situation...

Tell us if there are other considerations we should know about

Legal guardianship status

I am the participant's legal guardian or legal decision maker

The nominee is the participant's legal guardian or legal decision maker

Someone else is the participant's legal guardian or legal decision maker

Tell us if there is a legal guardian

Legal guardianship status

I am the participant's legal guardian or legal decision maker

Someone else is the participant's legal guardian or legal decision maker

Tell us if there is a legal guardian

Participant's circumstances

Describe the participant's situation or other considerations

Interpreters and communication

Describe your communication support needs

Interpreters and communication

Describe the participant's communication support needs

Upload communication support documents

Select files

You can upload a total of 3 .pdf, .doc, .docx, .png, .gif, .jpg, .jpeg, .jpe, and .xlsx files. Each file must be less than 4mb

Behaviour plan and supports

Describe your behaviour support support needs

Behaviour plan and supports

Describe the participant's behaviour support needs

Upload behaviour support documents

Select files

You can upload a total of 3 .pdf, .doc, .docx, .png, .gif, .jpg, .jpeg, .jpe, and .xlsx files. Each file must be less than 4mb

Emergency contact details

Who is your next of kin or emergency contact?

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Who should we contact in an emergency as your next of kin?

My legal guardian or legal decision maker is my emergency contact

Someone else is my emergency contact

Tell us who your emergency contact person is

Enter relationship

Enter how the emergency contact is related to yourself

Relationship to yourself

What is the emergency contact's relationship to yourself?

Emergency contact's name

Enter title

Type in the emergency contact's title

Title

Select the emergency contact's title

First name

Enter the emergency contact's first name

Middle name

Last name

Enter the emergency contact's last name

Emergency contact's phone number

Phone number

Enter the emergency contact's phone number

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Emergency contact details

Who is the participant's next of kin or emergency contact?

Who should we contact in an emergency as the participant's next of kin?

I am the participant's emergency contact

Someone else is the participant's emergency contact

Tell us who the participant's emergency contact person is

Who should we contact in an emergency as the participant's next of kin?

I am the participant's emergency contact

The nominee is the participant's emergency contact

Someone else is the participant's emergency contact

Tell us who the participant's emergency contact person is

Who should we contact in an emergency as the participant's next of kin?

I am the participant's emergency contact

The participant's legal guardian or legal decision maker is their emergency contact

Someone else is the participant's emergency contact

Tell us who the participant's emergency contact person is

Who should we contact in an emergency as the participant's next of kin?

I am the participant's emergency contact

The nominee is the participant's emergency contact

The participant's legal guardian or legal decision maker is their emergency contact

Someone else is the participant's emergency contact

Tell us who the participant's emergency contact person is

Enter relationship

Enter how the emergency contact is related to the participant

Relationship to participant

What is the emergency contact's relationship to the participant?

Emergency contact's name

Enter title

Type in the emergency contact's title

Title

Select the emergency contact's title

First name

Enter the emergency contact's first name

Middle name

Last name

Enter the emergency contact's last name

Emergency contact's phone number

We need your phone number if you are the emergency contact

We need the nominee's phone number if they are the emergency contact

Phone number

Enter the emergency contact's phone number

Phone number

Enter your phone number

Phone number

Enter the nominee's phone number

Guardianship details

Legal guardianship arrangements

Enter relationship

Enter how the legal guardian is related to yourself

Relationship to yourself

What is the legal guardian's relationship to yourself?

Enter relationship

Enter how the legal guardian is related to the participant

Relationship to participant

What is the legal guardian's relationship to the participant?

Other information

Enter any comments about the legal guardianship arrangements

Upload guardianship documents

Select files

You can upload a total of 3 .pdf, .doc, .docx, .png, .gif, .jpg, .jpeg, .jpe, and .xlsx files. Each file must be less than 4mb

About the legal guardian

Legal guardian's name

Organisation name

Enter the name of legal guardian's organisation

Legal guardian's organisation

The legal guardian is an organisation, not an individual person

Is the legal guardian an organisation or an individual?

Enter title

Type in the legal guardian's title

Title

Select the legal guardian's title

First name

Enter the legal guardian's first name

Middle name

Last name

Enter the legal guardian's last name

Legal guardian's contact details

First name

Enter the contact person's first name

Last name

Enter the contact person's last name

Legal guardian's preferred contact method

Contact them via email

Contact them via phone call

Choose how we should contact the legal guardian

Email address

Enter the legal guardian's email address

Phone number

Enter the legal guardian's phone number

Email address

We will use the email address as an alternative contact method for the legal guardian

Phone number

We will use the phone number as an alternative contact method for the legal guardian

Support preferences

Your support goals

Support preferences

Participant's support goals

What I want my supports to achieve

Do you have any goals that you want to work towards with your supports?

What the participant wants their supports to achieve

Does the participant have any goals that they want to work towards with their supports?

When and where

Support schedule

Regular, ongoing supports

Once-off supports

How often are these supports needed?

Provide shift dates and times

I will provide the details now

The support dates and times will be provided later

We can get these details now or later when we make contact to confirm the referral

Individual support shift

Support date

Select or enter the date when the support shift is needed

Minimum shift length is 2 hours.

Shift start time

Select or enter the shift start time

Shift end time

Select or enter the shift end time

The shift will cross midnight and continue into the next day if:

You select an end time that is less than 2 hours after .
You select an end time that is before .

Selected shift time: - .

Ongoing support days

Start date

Select or enter the date when the first support shift is needed

If you know what days these ongoing supports are needed, you can let us know

Minimum shift length is 2 hours.

Monday

Select if supports are required on this day

Shift start time

Select or enter the shift start time

Shift end time

Select or enter the shift end time

Day not selected.

The shift will cross midnight and continue into the next day if:

You select an end time that is less than 2 hours after .
You select an end time that is before .

Monday shift times: - .

Tuesday

Select if supports are required on this day

Shift start time

Select or enter the shift start time

Shift end time

Select or enter the shift end time

Day not selected.

The shift will cross midnight and continue into the next day if:

You select an end time that is less than 2 hours after .
You select an end time that is before .

Tuesday shift times: - .

Wednesday

Select if supports are required on this day

Shift start time

Select or enter the shift start time

Shift end time

Select or enter the shift end time

Day not selected.

The shift will cross midnight and continue into the next day if:

You select an end time that is less than 2 hours after .
You select an end time that is before .

Wednesday shift times: - .

Thursday

Select if supports are required on this day

Shift start time

Select or enter the shift start time

Shift end time

Select or enter the shift end time

Day not selected.

The shift will cross midnight and continue into the next day if:

You select an end time that is less than 2 hours after .
You select an end time that is before .

Thursday shift times: - .

Friday

Select if supports are required on this day

Shift start time

Select or enter the shift start time

Shift end time

Select or enter the shift end time

Day not selected.

The shift will cross midnight and continue into the next day if:

You select an end time that is less than 2 hours after .
You select an end time that is before .

Friday shift times: - .

Saturday

Select if supports are required on this day

Shift start time

Select or enter the shift start time

Shift end time

Select or enter the shift end time

Day not selected.

The shift will cross midnight and continue into the next day if:

You select an end time that is less than 2 hours after .
You select an end time that is before .

Saturday shift times: - .

Sunday

Select if supports are required on this day

Shift start time

Select or enter the shift start time

Shift end time

Select or enter the shift end time

Day not selected.

The shift will cross midnight and continue into the next day if:

You select an end time that is less than 2 hours after .
You select an end time that is before .

Sunday shift times: - .

We will discuss these details further when we get in touch to confirm the referral.

Support location

My supports will be based at my address

My supports will be based at a different address

Where do you need these supports, or where will we meet you for support shifts?

Support location

Their supports will be based at their address

Their supports will be based at a different address

Where does the participant need these supports, or where will we meet them for support shifts?

Street address Line 1

Street address Line 2

Enter the street address

Suburb

Enter the suburb

Postcode

Enter the postcode

State

Country

Support team

Do you have any worker preferences?

Would you like to work with certain workers, or workers who have specific skills, etc…

Does participant have any worker preferences?

Would the participant like to work with certain workers, or workers who have specific skills, etc…

Safety checklist

Keeping you and our team safe

Safety checklist

Keeping participants and our team safe

The safety of our clients and team members is our top priority, please answer the following questions so we can look after everyone’s safety as best as possible.

Are you prone to falling, slipping or tripping?

Yes

Please answer Yes or No

Is the participant prone to falling, slipping or tripping?

Yes

Please answer Yes or No

Describe the risk

Enter details about the risk

Do you need assistance with transfers to or from sitting down, getting in or out of bed or getting in and out of vehicles?

Yes

Please answer Yes or No

Does the participant need assistance with sitting down, getting up from sitting or getting in and out of vehicles?

Yes

Please answer Yes or No

Describe the risk

Enter details about the risk

Is there anything else we should know about you to keep you safe?

Yes

Please answer Yes or No

Is there anything else we should know about the participant to keep them safe?

Yes

Please answer Yes or No

Describe the risk

Enter details about the risk

Are there any weapons at the location where supports will be provided?

Yes

Please answer Yes or No

Describe the risk

Enter details about the risk

Does anyone smoke at the location where supports will be provided?

Yes

Please answer Yes or No

Describe the risk

Enter details about the risk

Is there any alcohol or drug use at the location where supports will be provided?

Yes

Please answer Yes or No

Describe the risk

Enter details about the risk

Is there anybody at the location where supports will be provided that could present a risk of contagious diseases?

Yes

Please answer Yes or No

Describe the risk

Enter details about the risk

Is there anything else that you believe may be a risk at the location where supports will be provided?

Yes

Please answer Yes or No

Describe the risk

Enter details about other known risks

Confirm referral

Additional comments

Before you send your referral, feel free to leave us any other comments or questions below.
We will assist with these comments and questions when we get in touch to confirm the referral.

Comments

Enter your comments

Comments

Enter your comments

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