Refer a Participant

NDIS Referrals

Submit a referral for a participant who needs NDIS support. Our team will review your referral and be in touch promptly.

Online Referral

Submit a referral online

Complete the form below to refer a participant to My Simple Support. Fields marked * are required. Our team will be in touch with you and the participant promptly.

In an emergency, call 000 This form is for referrals and general enquiries only. If someone is in immediate danger, please call Triple Zero (000).

About you (the referrer)

Your full name *

Role / Title *

Organisation (if applicable)

Relationship to participant *

Phone *

Email *

Participant details

Participant full name *

Date of birth *

Phone / mobile

Suburb / postcode *

NDIS number

Plan management type

Current living arrangements

Plan manager details

Plan manager / organisation

Plan manager phone

Plan manager invoicing email

Preferred language / communication needs

Safety & additional information

Health, safety or medical considerations

Additional notes

Supporting documents (optional)

Attach any relevant reports or plans to help us prepare for the participant's support. Accepted formats: PDF or Word (.doc, .docx).

Behaviour Support Plan

Drop file here or browse PDF or Word document

Allied Health Reports

Drop file here or browse PDF or Word · up to 3 documents