Referrals

Make a referral.

You can refer yourself, a family member, or a participant you support. We'll be in touch within 2 business days.

Submissions are encrypted in transit and stored privately. Only authorised staff can view them.

About you (the referrer)

Your relationship to the participantYour nameEmailPhone (optional)Organisation (optional)

About the participant

Participant's nameDate of birth (optional)Phone (optional)Email (optional)Suburb / address (optional)

NDIS plan

NDIS number (optional)Plan managementSupport requestedUrgency

Reason for referral

What's going on, and what would help?Current supports (optional)Risk or safety notes (optional)

Attach a document (optional)

PDF, Word, JPG or PNG up to 10MB. Stored privately.

Choose file

Consent

I consent to being contacted by Copacetic Support Coordination about this referral. I understand the information provided will be kept securely and shared only with people necessary to provide support.

We'll respond within 2 business days.