Support Coordination Enquiry

SUPPORT COORDINATION

We currently have limited availability for Support Coordination, but we are working on this.

Please feel free to submit an enquiry and our friendly staff will be in contact.

Support Coordination & Specialist SC Enquiry

Thank you for taking the time to register your interest to access Support Coordination and Specialist Support Coordination with The Carers Place. The information provided in this form is private and confidential and will help us ensure you access the support you require in a more efficient way and match you with the most appropriate support for you.

Date*
Date Format: DD slash MM slash YYYY
Name of Person Making Enquiry
First Last
Phone*
Email
Address*
Suburb State
Participant Name
First Last
Date of Birth
Date Format: DD slash MM slash YYYY
Do you have a current NDIS Plan*
- YES
- NO
- WAITING FOR A NEW PLAN
What date is your plan due for review with the NDIS
Date Format: DD slash MM slash YYYY
What support do you have an allocation for in your plan?*
- Support Coordination (SC)
- Specialist Support Coordination (SSC)
- Recovery Coaching (RC)
- Independent Living Options (ILO)
- Other
How many hours of SC, SSC or RC are remaining in your plan?*
Please select all that apply specific to you/the participant*
This section is optional however it will help us to determine if we can support you now and who the best consultant will be to support you or your loved one.
- Autism Spectrum Disorder
- Intellectual Disability
- Brain Injury
- Down Syndrome
- Multiple Sclerosis
- Chromosomal Deletion and Associated Disorders
- Physical Disability
- Mental Health Concerns
- Complex Health Needs
- Drugs and Alcohol
- Homelessness
- Housing Requirements / Specialist Disability Accommodation
- Life Transition ie. School Leaver / Seeking Employment
- No informal supports
- Residing in Hospital or Aged Care Facility
- Palliative Care
- Other
Is there anything else you think we should know or further information you would like to share?
NDIS Plan
ONLY attach your plan IF you have permission and we have discussed this already.
Accepted file types: pdf, jpg.
Do you require an interpreter? Please specify below:
Phone
This field is for validation purposes and should be left unchanged.