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ENQUIRIES 
 

If you have a referral enquiry and would like to check our capacity before completing the full referral form, please do not hesitate to submit this form or contact us at admin@otplus.net.au

We ask that you provide the following information about the participant(s):

  • Age

  • Location

  • Urgency of the referral

  • Reason for referral

At OT Plus, we provide occupational therapy services for adults (18+) with NDIS funding.

If you would like to refer someone for OT support, please complete the Referral Form below.

If you’d prefer to check our current capacity before making a full referral, please complete the Enquiry Form on the left-hand side of this page. A member of our admin team will be in touch to let you know if we’re able to assist. If we can help, we’ll then invite you to complete the Referral Form.

Referrals are reviewed as part of our weekly intake process every Wednesday. This allows us to ensure our team has the right skills and resources to provide the best possible support for each participant.

Once your referral has been reviewed, we’ll contact you to confirm acceptance and discuss the next steps.

OCCUPATIONAL THERAPY PLUS

NDIS REFERRAL FORM

CLIENT DETAILS

Birthday
Day
Month
Year

RELEVANT MEDICAL HISTORY/ DISABILITY INFORMATION

ALTERNATIVE CONTACT / PLAN NOMINEE

Is the alternative contact the plan Nominee?
Yes
No

ADDITIONAL INFORMATION

Who will be signing the service agreements?
Are there previous reports available
Yes
No
Is the NDIS plan available to share?
Yes
No

NDIS PLAN DETAILS

How is the plan managed

PLAN MANGEMENT DETAILS

SUPPORT COORDINATOR /LOCAL AREA COORDINATOR DETAILS

REASON FOR REFERRAL

Urgency
Please select work to be completed
Does this plan have funding periods?
Yes
No

RISK ASSESSMENT

Are there any known issues with

REFERRER INFORMATION

Person completeing the form
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1300 933 122

125 Prince Street, Orange NSW 2800

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