Select Page

Self Referral – Client Form

We accept referrals from families, carers / guardians and support coordinators. The client being referred must have a confirmed diagnosis of autism.

Between now and the start of 2022 we will only be accepting referrals for Local Programs (Outreach), Dookie Campus and Mansfield Campus.

If you are interested in our other services, please submit our Expression of Interest form, and we will contact you when referrals are being accepted.

Referral Form

STEP 1

REFERRAL FORM

Complete this Self Referral Form and provide Mansfield Autism with a copy of the client’s autism diagnosis.

Phone call

STEP 2

PHONE CALL

The service access team leader will be in touch to discuss availability of service, any wait lists and to arrange an access interview.

Interview

STEP 3

ACCESS INTERVIEW

The access interview varies according to service type. The interview may be in the family home, over the phone or at our education settings (combined with a school tour).

Service Agreement

STEP 4

SERVICE AGREEMENT

For NDIS services: a service agreement and schedule of support is signed. For educational services: An offer of place is made and an enrolment form and agreement is signed.

Service Starts

STEP 5

SERVICE STARTS

Staff will be in touch to arrange days / dates of service or school enrolment start dates.