Intake
Fill in our intake form and we will contact you to begin planning your supportIntake Process
- Complete the application form
- Intake Team will contact the referrer to discuss the application
- Management reviews all applications every Thursday
- Intake Team will contact the referrer in relation to the outcome
- If approved: Meet & Greet will be organised for the Service Agreement to be signed
- Services will then commence
Please note: This process may take up to 2 weeks to be completed
Application for Support Coordination
We have revised our application process to be more streamlined to eliminate unnecessary wait times for participant intake. This application form will take approximately 10 to 20 minutes to complete. If you require support in completing this form, please contact our Intake Team on 03 8407 0940.
Application for Support Coordination
We have revised our application process to be more streamlined to eliminate unnecessary wait times for participant intake. This application form will take approximately 10 to 20 minutes to complete. If you require support in completing this form, please contact our Intake Team on 0405 844 761 or 03 8407 0940.
Application for Support Coordination
We have revised our application process to be more streamlined to eliminate unnecessary wait times for participant intake. This application form will take approximately 10 to 20 minutes to complete. If you require support in completing this form, please contact our Intake Team on 0405 844 761 or 03 8407 0940.
Application for Support Coordination
We have revised our application process to be more streamlined to eliminate unnecessary wait times for participant intake. This application form will take approximately 10 to 20 minutes to complete. If you require support in completing this form, please contact our Intake Team on 0405 844 761 or 03 8407 0940.
Application for Support Coordination
We have revised our application process to be more streamlined to eliminate unnecessary wait times for participant intake. This application form will take approximately 10 to 20 minutes to complete. If you require support in completing this form, please contact our Intake Team on 0405 844 761 or 03 8407 0940.
Referrer Details
Does the participant give you consent to complete this form that includes their personal information?
How did you hear about Including You?
Participant Details
Which of the following most accurately describe(s) you?
Do you reside by yourself?
Preferred methods of contact
Do you have a Guardian or Advocate?
Emergency Contact
Parent/Guardian 1 (If applicable)
Additional relationship options
Parent/Guardian 2 (If applicable)
Additional Relationship Options
NDIS Plan Information
Funding Allocation
What type/s of Support Coordination are you funded for?
Support Coordination Invoicing Arrangement
Service Providers Currently In Use
Is the participant or a member of their family involved in Child Protection?
Are any family services involved with the participant or their family?
About You
Do you identify as Aboriginal?
Do you identify as Torres Strait Islander?
If yes, would you like Including You to provide you with a list of ACCOs that provide similar services so you may choose to access these if appropriate?
Do you identify as part of the LGBTQIA+ community?
Is an interpreter required?
Are there Behaviours of Concern present?
If yes, please list relevant behaviours (This helps ensure that we are appropriately supporting the participant)
Areas of Support
Which of the following areas would you like support in?
Do you also require Direct Support through Including You?
Is there any other information you would like Including You to know about you?
I declare that to the best of my knowledge, the information provided in this application is true, correct, and accurate.
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.
