Client Onboarding Form

  • Client Onboarding Form

  • Are you filling in the form for yourself or on behalf of someone?*
  • How will our services be funded?*
  • Please select the services you are seeking:
  • Your relationship to the Client

  • Client Details

  • DOB*
     / /
  • Date
     - -
  • Gender
  • Phone Number type
  • How would you like to be contacted for future correspondence?

  • Service and Funding Details

  • How is the plan funding managed?*

  • Thank you for considering our services. Unfortunately, as a registered NDIS provider, our current registration does not permit us to support clients who are under 9 years of age and agency-managed. We understand how important it is to find the right support, and we regret that we’re unable to assist in this instance. 

  • NDIS Plan Start Date*
     - -
  • NDIS Plan End Date*
     - -
  • How would you like to enter NDIS goals
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  • Does the client have a plan nominee?*

  • *A plan nominee is someone formally appointed by the NDIA to make decisions and manage NDIS funds on the client's behalf

  • Service Information and Budget Allocation

  • What services do you require?*
  • Please specify your preferred location for the sessions.
  • Please specify your preferred location for the sessions.
  • Please specify your preferred location for the sessions.
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  • Therapy Preparation

    Please note that the information requested in this section is for preparation purposes only and is not required to be fully completed. It is perfectly okay to leave any section blank or provide only what you feel comfortable with. You can update this information at any time during your therapy journey.
  • Are you able to answer the below therapy preparation questions?*
  • Accommodation type

  • Safety, Well-Being, and Support Screening

    This section collects vital information to ensure a safe and supportive environment for clients and staff. It helps us understand specific needs and challenges that may affect care. Your responses, treated confidentially, are key to tailoring our services for the best outcomes.
  • Are you able to answer questions regarding home safety for the participant?*
  • Are you able to put any unrestrained animals outside/or away during the session?*
  • Do they have a current behavioural support plan (BSP) or are they in the process of getting one?*
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  • Please tick any that apply:
  • Please tick any that apply to the participant or household members who may be present during appointments:

  • Key contacts

  • Who is best to contact for appointments*

  • Primary Contact

    Can be client, support coordinator, family member etc.
  • Has the primary contact's information already been entered?*
  • Is the Primary Contact:

  • Emergency Contact

  • Has the emergency contact's information already been entered?*
  • Is the Emergency Contact:
  • How did you find us ?*
  • Should be Empty: