Rethink Mental Health Australia Referral Form
Your name
First Name
Last Name
Your best Contact details
Please enter a valid phone number.
Your Organisation
Clients Name
First Name
Last Name
Clients NDIS Number
Only if they have one
How are they managed
Plan Managed
Self Managed
NDIA Managed
Please Tick if Appropriate
Client Has Public Guardian As Assigned Decision Maker
Client has Trustee Involed for financial management
Client Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Clients Phone Number
Please enter a valid phone number.
Please pick the service you wish to refer to
After Hours Mental Health Support Line
Psychosocial Recovery Coaching
Solution Focused Counselling Services
Corporate Mental Health Training and Up-Skilling of your Staff
EAP Services for your staff
Rethink Foundation ball interest
Community Based Counselling/Psychotherapy
Funding Options
NDIS Psychosocial Recovery Coaching
NDIS Capacity Builing (Counselling Specific)
NDIS Core (Flexible funding)
Please write what we can do to help
We will be in touch the same day you send this to us to discuss the next steps
Submit
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