Skip to content

0493 962 801

[email protected]

Feedback

Referral

Home
About Us
Our Services
FAQ
Contact Us

Home
About Us
Our Services
FAQ
Contact Us

Make a Referral

Referring to One Community Services is easy; simply complete the form, and our friendly team will contact you soon.

Referrer Details

Relationship to participant *

Participant Details

Gender

Preferred method of communication

Attach NDIS Plan (or relevant section of the plan)

Plan Details

Is your plan

Self-managed Agency managed Using a plan management provider

About The Participant

Is participant under Public guardianship

Participant living situation

Is the participant of aboriginal or torres strait islander descent?

Does the participant have a current behavioural support plan?

If other, please describe

Does the participant have a current behavioural support plan? If yes, please attach the behavioural support plan

Cognition details

Communication

Hearing impaired interpreter required?

Languages spoken

English Aboriginal Spanish Hindi Arabic Portuguese Bengali Russian Japanese Punjabi Other

Language Interpreter required?

If other, which languages?

Is the participant of culturally and linguistically diverse background?

Personal care - requires assistance with

Shower/Bath Toileting Grooming Dressing Other

Mobility

Independent Assist Walking Stick Walking Frame Manual Hoist Shower Chair Wheelchair L Frame Ceiling Hoist Other

Primary Disability

Secondary Disability

Other relevant information about the participant

Do you have any legal issues that may affect services?

Shifts

Preferred start date

How did you hear about us?

If other, please describe

Preferred Shifts days and times

Monday - AM Monday - PM Monday - Sleepover Monday - Active Nights Tuesday - AM Tuesday - PM Tuesday - Sleepover Tuesday - Active Nights Wednesday - AM Wednesday - PM Wednesday - Sleepover Wednesday - Active Nights Thursday - AM Thursday - PM Thursday - Sleepover Thursday - Active Nights Friday - AM Friday - PM Friday - Sleepover Friday - Active Nights Saturday - AM Saturday - PM Saturday - Sleepover Saturday - Active Nights Sunday - AM Sunday - PM Sunday - Sleepover Sunday - Active Nights

Shift Requirements

What services do you require?

Accommodation (SIL, MTA,STA) Community Access Transportation ⁠In home support Personal care Support Coordination Others

In-home support Community access Personal care Respite Care Other

Acknowledgement of Country

We acknowledge the traditional owners and custodians of the land where we located and working, the Arrernte people, and pay our respects to their Elders past, present and their future leaders.

Important Links

Work With Us
Make a Referral
Our Privacy Policy
Feedback & Complaints

Our Services

Supported Independent Living
Short Term Accommodation
Personal Support
View All Services

Contact Details

48 Gap Road, The Gap, NT, 0870
0493 962 801
[email protected]
Mon to Sat: 8 AM to 4:30 PM.

Designed By: Khalsa Website Designers

Instagram Linkedin Youtube

Enquire Now

Click To Call

error: