Whether you are a case manager, allied health professional, family member or looking for support for yourself, we look forward to working collaboratively with you. Simply complete our enquiry form below and one of our friendly team members will be in touch within 24-hours.
Alternatively, if you would like to speak to our Client Relationship team call 1300 737 942.
1. Fill out and submit the online form below.
Is the Enquirer the Participant?:
–None–
Yes
No
Relationship to the Participant?:
–None–
Other
Referrer
Allied Health
Associated Provider
Crisis housing provider
Disability Liaison Officer
Hospital
LAC
Other family member
Parent
Sibling
Social Worker
Spouse
Support coordinator
Spec Support Coordinator
Case Manager
Behaviour Support Practitioner
Family Member
Select how you heard about us:
–None–
Current CareChoice client
CareChoice website
Digital advertising
CareChoice event
Hospital/Rehab
NDIS
SDA Options
SDA Provider
Social media
Support coordinator
Housing Hub website
Expo
Allied Health Professional – Occupational therapist
Allied Health Professional – Speech Pathologist
Behaviour Support Practitioner
Case Manager
DFFH
DSG newsletter
Event
Facebook
Family/friend
Go Nest website
Google
Guardian / OPA
Instagram
Kismet
Medical Professional
MyCareSpace
NDIS – LAC
NDIS – Plan Manager
Link Disability Magazine
CareChoice newsletter
Clickability
Industry Newsletter
Disability Services Guide website
Previous CareChoice client
Other
Participant’s First Name:
Participant’s Last Name:
Participant’s date of birth:
Participant’s gender:
–None–
Male
Female
Intersex
Declined to Answer
Other
Non-binary
Transgender
Nature of disability:
Is there a current NDIS plan available?:
–None–
Yes
No
Unsure
What services are you interested in?:
Support required? Days/times/activities:
Participant Residential Address (ZIP/Postal Code):
Anything else you think we should know?:
I have read and agree to Privacy Statement:
CareChoice is registered to provide services for TAC and WorkSafe clients
Registered NDIS Service Provider
CareChoice acknowledges the support of the Victorian Government
CareChoice is partnered with NDISDA
CareChoice is partnered with NDS
Australasian Association of Forensic Disability
