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.
Complete this Self Referral Form and provide Mansfield Autism with a copy of the client’s autism diagnosis.
The service access team leader will be in touch to discuss availability of service, any wait lists and to arrange an 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).
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.
Staff will be in touch to arrange days / dates of service or school enrolment start dates.
Referrals must be accompanied by a copy of your child’s autism diagnosis. Please have a copy of the diagnosis ready for upload.
This can be uploaded at the bottom of this form. The option to upload a copy of the NDIS Plan or DHHS Targeted Care Package is also at the bottom of this form.