NDIS Referral Form: Template and Provider Guide
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care referral and information sharing template
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Search for “NDIS referral form” and you will find dozens of documents, all different, most of them made up by the organisation publishing them. That is not a scandal. It reflects something true about how the scheme works, and it is worth understanding before you download anything.
There is no single national NDIS referral form
The NDIA does not publish one. There is no form number, no version, no template on ndis.gov.au that a provider is meant to use when passing a participant to another service.
What the NDIA does publish is different, and the three things get confused constantly.
The Access Request Form. This is how a person applies to become an NDIS participant. A treating health professional completes part of it. It goes to the NDIA, not to a provider. If someone is not yet in the scheme, this is the document they need, and no provider referral form substitutes for it.
Requests for service through the my NDIS provider portal. When a participant tells the NDIA which support coordinator or recovery coach they want, the NDIA sends that provider a request for service through the portal. The participant chooses. The provider accepts or declines. This is a real, structured referral pathway, but it is only for support coordination and recovery coaching, and it is generated by the agency rather than filled in by hand.
Everything else. A hospital discharge planner sending someone to an in-home support service. A support coordinator connecting a participant to a physiotherapist. A GP passing a family to a provider. None of these run through an NDIA form. The referring organisation writes its own, or writes an email, or makes a phone call.
So when a provider asks for an NDIS referral form, they almost always mean the third thing. They want a structured document to send and receive, so referrals stop arriving as three-line emails with no consent record and no contact number.
Why the form matters more than it looks like it should
A referral is the moment a participant’s information leaves your organisation. That makes it a privacy event, not just an administrative one.
Under Australian privacy law, health information can generally only be used or disclosed for the purpose it was collected, or with the person’s consent. The Office of the Australian Information Commissioner’s health privacy guidance sets out how that works for health service providers. A referral is a disclosure to a third party, and a service agreement signed eight months ago is not a consent to it.
For registered providers there is a second layer. The NDIS Practice Standards core module covers the provision of supports, including how a participant is supported to access services and how information about them is handled. Auditors read referral records. A referral with no recorded consent and no named recipient is the kind of gap that turns into a corrective action.
Providers working with self-managed and plan-managed participants do not go through the same audit, since those participants may use unregistered providers. The privacy obligations still apply, and so does the practical risk of sending the wrong information to the wrong service.
What belongs on an NDIS referral form
Keep it to what the receiving service needs to decide whether it can help. The test is not “what do we know about this person” but “what does the next service need to act”.
The person and how to reach them
Name, preferred name, date of birth, address, phone and email. Who else can be contacted and what their authority is. A family relationship on its own does not make someone a decision maker.
Record communication needs here rather than burying them in a narrative field. Interpreter language, Auslan, low vision, plain language, best time of day to call. A referral that omits the interpreter requirement produces a failed first appointment.
Who is referring and why
Your organisation, the named person making the referral, and a direct contact for questions. Then the reason, in one or two sentences that a stranger can act on. “Needs more support” is not a referral. “Discharged from hospital 8 September after a fall, needs personal care twice daily and a home safety review before the current arrangement ends on 30 September” is.
What is being requested
The service, the frequency, the location, and any worker skills or characteristics the participant has asked for. Say what has already been tried and did not work, because otherwise the next service repeats it.
Funding and plan management
Whether the person is an NDIS participant, an aged care client, privately funded, or waiting on an outcome. Plan management type matters immediately, because it determines who the receiving provider invoices and whether a service booking is needed. Plan dates matter because a plan ending in three weeks changes the urgency.
Do not attach the whole plan by default. Share the relevant budget category and support description, and only if the participant has agreed to it.
Risk and safety
Anything the receiving service needs before the first visit. Medication support requirements, mealtime management needs, behaviour support in place, home access issues, pets, known safety concerns for lone workers. Be specific and attribute information that came from someone else.
Urgency and response
When the support is needed, what happens if it is not available, and a date you will follow up. Then actually follow up. An unanswered referral is the most common failure point in the whole process, and it is invisible unless someone owns the date.
Consent
The person making the decision, exactly what information is being shared, who is receiving it, for what purpose, for how long, and how to withdraw. The NDIA’s guidance on giving consent covers the NDIA side. Your own consent record covers the rest.
What is in the download
The care referral and information sharing template covers both halves of this in one Word document: a service referral section and a separate information sharing record. The second part exists because consent is usually the piece people skip.
It works for NDIS referrals, aged care referrals and allied health enquiries, which is deliberate. Most providers doing NDIS work also take aged care and private clients, and running three near-identical forms is how the consent section quietly falls off two of them.
It is a starting draft, not an approved form. The NDIA and the NDIS Commission have not reviewed it. Adapt it to your own privacy policy, your state’s requirements and the services you actually deliver, and remove the sections that do not apply.
Four things that go wrong
Sending the whole plan. It is the fastest way to over-disclose. The receiving service needs the funding category, not the participant’s goals, funding totals and diagnostic history.
Treating a referral as an acceptance. It is a request. Capacity, coverage and skill match all still have to be checked by the receiving service.
No named contact. A referral from “intake@” with no person attached loses two days to routing every time a question comes up.
Consent recorded once, then reused. Consent is specific. Referring the same participant to a second service six months later needs its own record.
Next steps
Once a referral is accepted, the receiving provider needs intake details and an agreement. The participant intake form picks up where the referral stops, and the service agreement template records what was agreed. If you are building a referral pipeline rather than handling one-off cases, the guide to building a support coordinator referral network covers the relationship side.
Browse all the free templates. These documents support the work of providers, coordinators and participants. Carevo is a connection platform: it does not deliver supports, employ workers, or review the documents providers use.
If you need to place a participant with a service, refer a participant to providers.
This is general information, not legal or clinical advice. Obtain advice for privacy, consent or contractual questions outside the template’s scope.
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Andre is the co-founder and CEO of Carevo. He holds a Bachelor of Commerce, majoring in Marketing, and a Bachelor of Arts from UNSW Sydney, where his majors were International Relations, Politics, Information Systems, and Media and Communications, graduating in 2014, and went through the UNSW 10x Founders accelerator in 2023.
