Make a Referral | BORS Community Services

BORS Referral Pathway

Refer a participant for safe, person-centred support

Complete the form below with as much information as available. Our intake team will review the referral, confirm consent and contact the nominated person for next steps.

1. Participant details2. NDIS plan & contacts3. Services required4. Submit documents

01 Referrer Details

Referrer Name

Organisation

Phone

Referral Source

Relationship to Participant

02 Participant Details

Participant Name

Date of Birth

Phone

Gender

Primary Disability / Support Need

Address

Suburb / Location

NDIS Number

03 NDIS Plan and Contacts

Plan Start

Plan End

Plan Management Type

Urgency

Support Coordinator Name

Support Coordinator Email

Support Coordinator Phone

Guardian / Nominee Name

Guardian Phone

Guardian Email

04 Services Required

Personalised Disability Support Services Accommodation Assist Travel and Transport Skills Acquisition Programmes Social, Civic and Community Participation Group and Centre Activities Service for Rural and Remote Area Participants Support Coordination BORS Consultancy Services

Preferred Start Date

Preferred Contact Method

Preferred Contact Time

Behaviour Support Plan?

Restrictive Practices?

Consent to Contact

05 Support Considerations

Communication Needs

Cultural / Language / Spiritual Considerations

Medical Alerts, Allergies or Health Considerations

Additional Notes / Support Goals

Upload NDIS Plan / Consent / Supporting Document

Additional Information

Preferred service daysExample: Monday, Wednesday, Friday

Interpreter requiredSelect whether communication/interpreter support may be required.

By submitting, you confirm that the information provided is accurate and that appropriate consent has been obtained where required.