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National Choice Care

For professionals

Refer a client or patient

Choose the referral type that matches their funding. Our intake team reviews referrals every business day.

Fast response

We confirm receipt within one business day.

Consent first

Only share information the person has agreed to.

Prefer to talk?

Call our intake team on 0493 023 100.

Demo mode: this form is not yet connected to a submission service. Nothing you type is sent or stored. To reach a real person, call 0493 023 100.

About you (the referrer)

e.g. support coordinator, discharge planner

About the participant

9 digits, if known

Services requested
Relevant history

Only include information the person has agreed you can share.

Attachments

File uploads are not available yet — {{FILE_UPLOAD_REQUIRES_BACKEND}}. Please keep any documents and we'll arrange a secure way to share them when we contact you.