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Your Contact Details

Let’s start with your contact details

Name *

Surname *

Telephone *

Email *

Company

I would prefer to be contacted

Any

Phone

SMS

Tell us about yourself

I am a *

What is the age of the person needing the service? *

Are there any complex behaviours or high needs? *

Yes

Not sure

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What supports are you looking for?

We can connect you with multiple service providers in a single request.

I am looking for *

Something else I need is...

Tell us about the support you need

Do you require a provider that has experience in a particular area, or with a particular disability? *

Yes

E.g.Domestic Violence, Homelessness, Children, the Justice System, Autism, Cerebral Palsy, Mental Health, LGBTQIA+

Experience detail

Do you require a worker/provider who speaks a language other than English? *

Yes

What language does the worker/provider need to speak?

Service Location and Timing

Where is the person needing the service located?

Letting us know your location will ensure you are connected to providers who deliver services in your area.

Your Suburb *

Your Postcode *

Your State *

When do you need these supports?

How frequently is the service required?

How many hours do you need the service (for per session/shift?)

Tell us about your plan

So that we can make sure we select providers that are able to support you.

How is your NDIS plan managed? *

Do you know when your plan expires?

Month

Year

Upload your NDIS Plan (optional)

Providing your plan is optional and will simply allow our team to provide you with the most suitable options and offer any support you need in understanding your plan

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To access services sooner, would you consider using Telehealth? *

What supports do you need?

The MyCareSpace Connections team will connect you with Service Providers that have capacity and the skills and experience you need.

Your Contact Details

Tell us about yourself

What supports are you looking for?

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Service Location and Timing

Tell us about your plan

Support
-Accessing the Community
-Personal Care
-Support Worker
-Help with Daily Tasks
-Nursing
-Mentor
Plan Support
-Plan Manager
-Support Coordinator
-Specialist Support Coordinator
-Recovery Coach (PRC)
-PBS Management
Allied Health (Therapies)
-Functional Capacity Assessment (FCA)
-Art Therapy
-Counselling
-Developmental Educator
-Dietician
-Exercise Physiology
-Key Worker
-Music Therapy
-Occupational Therapy
-Physiotherapy
-Podiatry
-Positive Behaviour Support Plan
-Psychology
-Psychotherapy
-Social Worker
-Speech Therapy
-Therapy Assistant
-Other Therapy (Sand, Animal, Play)
Home Maintenance
-Cleaning
-Gardening
-Yard Maintenance
-Handyperson & Repairs
Housing
-ILO
-Medium Term Accommodation
-Specialist Disability Accommodation (SDA)
-Supported Independent Living (SIL)
-Home Modifications
Social, Health & Wellbeing
-Social Activities and Programs
-Respite/Short Term Accommodation
-Family & Peer Support Groups
-Holistic Therapy
-Personal Training
Skills Development
-Budgeting & Finance
-Driving Lessons
-Computer Skills
-Mentoring
-Travel Training
Employment
-Support in Employment
-Finding and Keeping a Job
-SLES (Registered Provider)
Equipment
-Consumables
-Disability Aids
Children
-Early Intervention
Something else (let us know what)

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Hebrew
Hindi
Hungarian
Italian
Japanese
Korean
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Nepalese
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Portuguese
Punjabi
Romo
Russian
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Shona
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Spanish
Swahili
Tagalog
Tamil
Thai
Turkish
Urdu
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