NDIS Participant IntakeSupporting NDIS Participants

Refer to us! to LinktCare.

A secure, confidential intake form for NDIS participants, families and support coordinators across Western Melbourne & Geelong. We reply within 48 hours.

Confidential & Secure Reply within 48 hours Plan & Self-managed

Submit the form

Tell us about the participant and the supports they need using the secure form below.

We get in touch

Our intake team reads your referral and calls or emails you within 48 hours.

Support begins

We organise a personalised support plan and match the right workers to the participant.

Referral Intake Form

Tell us about the participant

Fields marked * are required. Everything you share stays confidential and is used only to organise the right supports.

Section 01

Participant information

Participant's Name *

Date of Birth *

Gender *

Primary Diagnosis *

Secondary Diagnosis

Participant's Phone Number *

Participant's Address

Participant's Email Address *

Section 02

NDIS details

How is the plan managed?

LinktCare supports plan-managed and self-managed participants. We are not able to take referrals for NDIA-managed plans.

Is there a funding period in place?

NDIS Number *

Plan Start Date

Plan End Date

Section 03

Reason for referral

Support services

Days support is needed

Approximately how many hours per day? *

Leave a message / Additional details

File upload (please attach a copy of the current NDIS plan if possible)

Click or drag a file to this area to upload

PDF, DOC, DOCX · up to 10 MB

Section 04

Referrer details

The person making the referral

Who is making this referral? *

Name *

Organisation / Relationship

Phone *

Email Address *

Who do we contact about this referral? *

Preferred day and time to be contacted back

Let us know when suits, and we will ring you then to discuss the referral.

Preferred day

Preferred time

I confirm I have the participant's consent to share this information with LinktCare so we can organise supports. *

🔒 Securely processed. We will get back to you within 48 hours.

Thriving Alliance Pty Ltd, trading as LinktCare, acknowledges the Traditional Custodians of the lands on which we work and live, and pays respect to Elders past and present. We welcome people of all abilities, cultures, identities and backgrounds.