Become an Enable Client

Please fill out all of the below fields to the best of your ability. If you need assistance, please ask a Guardian, Support or relative to help. The more information you provide, the better Support and Service we can plan.

 

Enquirer's Details

If you are filling out this application for yourself, or on behalf of a family member, friend or client, please fill in all fields below.


You are required to enter at least ONE contact method:


Which of our Enable offices are closest to the potential client? (please select one)

How did you hear about us?



Potential Client's Details

Please fill out in as much detail as possible, so we can gain a deep understanding of your needs.


You are required to enter at least ONE contact method for the potential client:

Potential Client's Preferred Contact Method: (please select one)
EmailPhone CallText/SMS

How do you communicate?





What Support Looks Like For You


What days would you be requiring Support for?
MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Would you be interested in accessing any of our Therapy services? If so, select which ones below:
Occupational TherapySpeech PathologyPhysiotherapyPsychology ServicesPositive Behaviour SupportNone



Please answer these as accurately as possible, so we can understand how best to help you or the person you're applying for.


Your NDIS Plan

Please upload your NDIS plan so we can assess your needs.

All files must be in either PDF or .docx format, and under 10mb to be uploaded.




Supporting Documents

Please upload any Therapy Reports, Medical Reports or Function Capacity Assessments you may have.

All files must be in either PDF or .docx format, and under 20mb to be uploaded.