Referrals

Make a Referral

Thank you for considering Lumen Therapeutic Services.

We welcome referrals from participants, families, carers, support coordinators, schools, service providers and allied health professionals.

If you are unsure whether Specialist Behaviour Support is appropriate for your situation, you can submit the form or email us and a member of our team will be happy to discuss your needs.

Who Are You?

Referrer Type *

Your Details

Full Name *

Organisation (if applicable)

Phone Number *

Email Address *

Participant Details

Participant Name *

Date of Birth

Phone Number

Email Address

NDIS Number (Optional)

Referral Information

Reason for Referral *

Current Concerns

Relevant Goals

Additional Information

Supporting Documents (Optional)

You may upload Behaviour Support Plans, NDIS Plans, Allied Health Reports, School Reports or other relevant documents. Up to 5 files, 10 MB each, 25 MB total.

Upload supporting documents

I confirm that I am authorised to provide this information and consent to Lumen Therapeutic Services collecting and storing it for referral assessment and service coordination in accordance with the Privacy Policy. *

Not Ready to Refer?

Talk to us first

If you would like to discuss your situation before making a referral, email us and a member of our team will be happy to assist.

Email Referral Enquiries

Or use the general contact page