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Home
Services
Who We Help
About
Referrals
I'm Seeking Work
I'm Seeking Support
Contact Us
Need to refer a participant to Flair?
Simply fill in and submit the referral form below. We’ll contact you as soon as possible to learn more about your support needs and how we can help.
Referrer Details
Name
(Required)
First
Last
Email
(Required)
Phone
(Required)
I would like to refer
(Required)
Myself
A Family Member
A Friend
A Participant (Support Coordinator or LAC)
Participant Details
Name
(Required)
First
Last
NDIS Number
(Required)
NDIS Plan Start Date
MM slash DD slash YYYY
NDIS Plan End Date
MM slash DD slash YYYY
Finances Managed by
Plan Managed
Self Managed
NDIA Managed
Please select the services that you're interested in accessing
(Required)
You can tick more than one box
Cleaning
Gardening
Domestic Assistance
Personal Care
Community Access
Group Programs
Allied Health Services (such as Physiotherapy, Occupational Therapy, Psychologist, Dietician, etc)
Do you have any special requests or notes about the service you would like?
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