Make a Referral

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Make an NDIS Referral with STARR Care in South Hedland

At STARR Care, we make the NDIS referral process in South Hedland simple and accessible. Whether you are a participant, family member, support coordinator, or healthcare professional, you can submit a referral using the form below and our team will guide you through the next steps.

Contact our friendly team at (+61) 487-468-829 or email us at info@starrcare.com.au. We are committed to supporting you every step of the way.

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New Referral Form

Referral Details

Name *

Name

First Name

Last Name

Email *

Phone *

Organisation *

Position

Referral Date *

Are you able to sign documents on behalf of the Client?

Yes

Client Information

Name *

Name

First Name

Last Name

Date Of Birth *

Gender *

Address *

Phone *

Email *

Living Arrangement

Alone

Family/Partner

Supported Accommodation

OtherOther

Funding Details

Funding Stream *

NDIS

Aged Care

DVA

Private

Funding Start Date *

Funding End Date *

Reference Number *

Invoices To *

Health Status

Disability

Allergies

Health Status

How can we assist your client?

What services is the client looking for? *

Does the client have any significant health issue, that if not managed immediately, may be life threatening?

Does the client have a condition that is contagious?

Does the client have any psychological concerns that may result in them causing harm to themselves or others?

Are there any communication or cultural factors that need to be considered in making contact with the client and/or their representative?

Please provide the contact details of any relevant treating practitioner

Please provide any other key information relating to the persons health and psychological needs

Has the client provided consent for personal information to be shared with us? *

Yes

Safety Information

Any harm from others identified? *

Yes

Any risk of self-harm identified? *

Yes

Are there any pets on the property? *

Yes

Any harm to others identified? *

Yes

Are there any firearms being stored on the property? *

Yes

Is there any history or current use of drugs at this property? *

Yes

Further Information

Any risk that we need to know (If yes, please specify below)

Any challenging behaviours that can assist our planning for your client? (If yes, please specify below)

If you are human, leave this field blank.

Request a Call Back

We are committed to supporting you in accessing the services you need. If you would like to speak with one of our team members, please complete the form, and we’ll get in touch with you.

As a registered NDIS provider, we are dedicated to helping you achieve your goals and enhance your quality of life.

ABN: 79650302060
ACN: 650302060

Services

Daily Living/Personal Care
Community Access/Participation
Positive Behaviour Support
Respite Care
Supported Independent Living (SIL)
Community Nursing
Mental Health Support

Reach Out

(+61) 487-468-829
info@starrcare.com.au
Unit 3, 3 Brand Street, South Hedland WA 6722
Monday - Friday : 08:00AM - 06:00PM
Public holidays: Closed
Saturdays & Sundays : Closed

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Thank you for being part of the STARR Care community. We are committed to making a difference in your life.

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