Support Services

Complete the Expression of Interest/Referral form, and our team will be in touch to arrange a meeting.

We’d love to learn more about you and how we can help.

1. What are your details (applicant)?

First Name

Last Name

Current Address

Phone Number

Date of Birth

2. If someone else is filling out this form, what are their details?

First Name

Last Name

Relationship to applicant

Organisation (if applicable)

Phone Number

3. Describe your disability(s)?

4.What is your current NDIS status?

NDIS participant with current plan NDIS participant waiting for plan approval NDIS participant waiting for planning meeting Waiting for NDIS eligibility approval

NDIS Number (if you have one)

Plan Start Date

Plan End Date

5. Please provide any additional medical support needs.

6. How are your supports currently managed?

Support Coordinator Self Managed Plan Manager Other

7. Other team supports

None Allied Health Other

Details

8. What are your interests and the type of services that you require?

If you would like to fill out a more in-depth intake form which allows us to further personalize our services to fit your needs please download the Full Intake Form here and email it to: support@assistlifestyle.com.au

If you would like to learn more about our services please download the PDF Brochure here

If you are interested to see our processes, operation policies, and procedures please download the Participant information booklet here

Assist Lifestyle acknowledges the Traditional Custodians of country throughout Australia and their connections to land, sea and community. We pay our respect to their Elders past and present and extend that respect to all Aboriginal and Torres Strait Islander peoples today. We also acknowledge the diversity of Australian culture and extend our support to all individuals, regardless of culture or sexuality.

Expression of Interest Intake Form

Ready to Start Your NDIS Journey on the Sunshine Coast?

CONTACT US

USEFUL LINKS

Acknowledgement of country