Referrals | YourStartup

Referral Program

Help Others Access Quality Care

Refer someone to our services and help them receive the support they need. Our streamlined referral process makes it easy to connect people with compassionate care.

Submit Referral

Fill out our comprehensive referral form with the person's information and support needs.

We'll Contact Them

Our care team will reach out to discuss services and arrange an initial assessment.

Quality Care Begins

They'll receive personalised care and support tailored to their specific needs.

Referral Form

Submit a Referral

Help someone access our care services by completing this form.

Select Service Type

Please select the type of service the individual requires:

Important Information & Consent

Please complete the form below to refer an individual for our services. At Alternative Care Solutions, we adhere to strict standards in receiving referrals.

All referral information must be provided with explicit consent from the client or their authorised family member. By submitting this form, you confirm that you have obtained such consent and that the details provided are accurate.

Our dedicated care team will review the referral and contact you promptly to discuss next steps and confirm the best approach for delivering care.

Privacy Notice: All information provided is treated with strict confidentiality and used solely for the purpose of providing care services.

NDIS Participant Information

Full Name *

Date of Birth *

NDIS Number *

Phone Number *

Email Address *

Home Address *

NDIS Plan Details

Plan Start Date

Plan End Date

Plan Management Type *

Aged Care Information

Full Name *

Date of Birth *

Phone Number *

Email Address *

Home Address *

Aged Care Details

Home Care Package Level

Package Provider

Other Services Information

Full Name *

Date of Birth *

Phone Number *

Email Address *

Home Address *

Service Requirements

Describe Required Services *

Contact Information

Primary Contact Name *

Relationship *

Phone *

Email *

Emergency Contact Information

Emergency Contact Name *

Relationship *

Phone *

Email *

Referrer Details

Your Name *

Organisation & Role

Your Phone *

Your Email *

Supporting Documents (Optional)

Upload any relevant documents such as behaviour plans, medical reports, or other supporting information.

Click to upload or drag and drop

PDF, DOC, DOCX, JPG, PNG, TXT (Max 10MB each)

Selected Files:

Files for submission:

⚠️ Form blocked: Remove ALL invalid files to enable submission

🚫 Form Submission Blocked

Remove all invalid files to enable submission

Referral Submitted!

Your reference number is:

Thank you for submitting your referral. Our care team will review it and contact you promptly to discuss next steps.

Why Refer to ACS?

We're committed to providing exceptional care and support. When you refer someone to us, you're connecting them with a team that values dignity, independence, and community.

Person-Centred Care

Every individual receives personalised support tailored to their unique needs and goals.

NDIS Expertise

Specialised knowledge of NDIS processes and support coordination.

Community Focus

Building connections and fostering community participation.

24/7 Support

Round-the-clock care and emergency support when needed.

Need Help with Referrals?

Our referral team is here to assist you with any questions about the process.

Call: +61 482 857 121

Email: [email protected]

If you would prefer a paper copy of our referral form, you can download it here, complete it, and then return it to our email.