REFER TO US

Help us understand your specific needs

Are you a Support Coordinator, family member, friend, or someone looking to engage highly skilled nurses for assistance with medical treatment?

Complete our referral form below to get started.

Referral Form

Your first and last name

Your contact telephone number

Your email

What best describes you?

How would you prefer to be contacted?

Name of the person requiring the service

Gender of the person requiring the service

Are they Aboriginal or Torres Straight Islander?

Suburb where the person needing the service is located

Primary disability or need of person needing the service

Age of the person needing the service

How is the NDIS plan managed?

Preferred gender of attendants

What additional language does the provider need to speak?

Is there a requirement for help with more complex needs? Please provide relevant details.

Does your provider need to have any specific skills? If so, please provide details.

What services are you looking for?

When do you need the service by?

I need

How did you find us?

Additional Information

I consent to LBS Support Services collecting and dealing with the personal information provided in this form in accordance with our Privacy Policy

Address

Thank you for your referral, your message has been sent

Commitment to Care

Completing our referral form is the first step in securing compassionate, professional care.

Please call us if you want to discuss anything further.

Call: 0429 616 732

LBS Support Services

LBS Estate Holdings t/as LBS Support Services

ABN: 80 645 150 545

NDIS Provider No: 1234567

Office Address: Unit 18 366 Great North Road, Abbotsford NSW 2046

Hours: Monday to Friday 9.00am - 5.00pm

Phone: 0429 616 732

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REFER TO US

Help us understand your specific needs

Referral Form

Commitment to Care

LBS Support Services

Social Media

Legal

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