NDIS Referral

Client Referral
& Intake Form

Submit a new referral for NDIS physiotherapy services with Broad-Ability Therapy. All fields marked with * are required. Information is handled in accordance with Australian privacy legislation.

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01 — Participant Details

Participant Information

Details of the NDIS participant being referred for physiotherapy services.

First name is required
Last name is required
Date of birth is required
Phone number is required
Address is required
Required
Required
Required
Format: 43 + 7 digits Must start with 43, 9 digits total
02 — Referral Source

Who Is Making This Referral?

Details of the person or organisation submitting this referral.

Please select a referrer type
Referrer name is required
Referrer email is required
03 — NDIS Plan Information

Plan Management & Funding

How the participant's NDIS plan is managed and funded.

Please select a plan management type
Plan Manager Details
Therapeutic Supports (CB Daily Activity)
NDIS Support Category 15 — Improved Daily Living
If known — total approved for therapeutic supports
04 — Clinical Information

Clinical & Service Details

Help us understand the participant's needs so we can prepare for the initial assessment.

Primary condition is required
Please select at least one service
Please select a preferred location
Please describe the participant's goals

You will receive a confirmation once the referral has been received.

Referral Submitted

Thank you. Your referral has been received by Broad-Ability Therapy. We will review the details and contact the participant (or referrer) within 2 business days to arrange the initial assessment.

A confirmation has been sent to the referrer's email address. If you have questions, contact info@broadability.com.au.

Service Information

Rates, Travel & Durations

Travel Charges

Provider travel is calculated based on distance from the Warners Bay clinic to the participant's address. Travel time is billed separately from appointment time under NDIS line item 15_799_0106_6_3 (Provider Travel — Non-Labour Costs) where applicable.

Service Rates

Service rates are set per the current NDIS Support Catalogue (Therapeutic Supports — Category 15). All physiotherapy services are GST-free under Division 38 of the GST Act. Rates are updated annually in line with NDIS pricing arrangements.

Standard Service Types & Durations

Service Typical Duration Description
Initial Assessment 60 – 90 min Comprehensive assessment, goal setting, and treatment planning
Standard Consultation 45 – 60 min Ongoing treatment, exercise review, and progress monitoring
Exercise Prescription 30 – 45 min Individualised exercise program design and instruction
Hydrotherapy 45 – 60 min Pool-based therapy for mobility, strength, and pain management
NDIS Report Non-contact Progress reports, AT assessments, plan review documentation
Assistive Technology 60 – 90 min Assessment, prescription, and fitting of assistive devices