Fill in our intake form and we will contact you to begin planning your support

Intake Process

  • Complete the online form
  • A member of staff will contact the referrer to discuss the service required.
  • Completion of additional forms.
  • Management will review the application.
  • Management will contact the referrer in relation to the outcome.
  • If approved: Service Agreement will be sent through to be signed.
  • Once service agreement is received, meet and greet will be arranged.

Please note: this process may take up to 2 weeks to be completed.

  • 1. Client Details

  • Date Format: DD slash MM slash YYYY
  • 2. Referrer Details

Non-Discrimination Policy

Including You believes in an inclusive service. This means we are committed to being an  inclusive and respectful service that welcomes all. Sex, gender ,identity, sexual orientation, age and religion.