Referrer's Name

Referring person's name

First Name

Last Name

Referrer's Email

Referrer's Profession/Position

Client Name

Parent/caregiver/nominee/guardian name

Client Date of Birth

MM

DD

YYYY

Client Phone and Email

Client Address

Participant NDIS Number and Plan Manager Email

Other Information

Email any reports, letters and background documents to don@socialsense.com.au

Referrals

With the consent of the client/patient, please complete this form to refer to Social Sense Allied Health.

We will then contact the client/patient via phone discussion, and if the referral is appropriate for our service, we will send the client/patient an electronic intake form for completion.

Following intake, we will also gain the client/patient’s consent to obtain specialist reports, letters and other documents to support their therapy and treatment at Social Sense Allied Health.

Information for General Practitioners

As an Accredited Mental Health Social Worker, we can provide services which attract a Medicare rebate for eligible patients. We specialise in anxiety, depression, trauma and neurodevelopmental conditions such as autism and ADHD.

For more information, please visit https://www.aasw.asn.au/professional/aasw-credentials/mental-health/ or download the brochure below.

Brochure for GPs

Referrals

Experts in Complexity.

Social Sense Allied Health