Start a Referral
Complete the referral form below to tell us about the participant, their support needs, strengths, goals and the services being requested.
Complete the Form
Provide the participant and referral information requested.
Our Team Reviews It
We consider the participant’s needs, goals and requested support.
We Make Contact
A Jupiter team member will contact the appropriate person.
Information You May Need
Having the following information available may make the referral form easier to complete.
- Referrer contact information
- Participant contact details
- Participant date of birth
- NDIS information where applicable
- Reason for the referral
- Requested services or supports
- Current supports and providers
- Participant goals and desired outcomes
- Participant strengths and interests
- Relevant risks or support requirements
Provide as Much Detail as You Can
Clear information helps our team understand the participant’s circumstances and determine whether Jupiter Supports may be able to provide suitable assistance.
Referrals may be completed by the participant, a family member, carer, support coordinator, health professional, school, government agency or another authorised person.
Please ensure that the participant or their authorised representative is aware that a referral is being submitted.
Contact Jupiter Supports if you need assistance completing the form or providing information in another way.
Complete the Jupiter Referral Form
Complete the fields below and submit the form when you are ready. Required questions will be marked within the form.
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Open the Referral Form in a New TabSharing Referral Information
Referral information should be provided carefully and only by people who have permission or authority to share it.
Participant Awareness
The participant or their authorised representative should be aware that the referral is being made.
Respectful Information
Information should be accurate, relevant and presented in a respectful and person-centred way.
Relevant Details
Include information needed to understand support requirements, safety, communication and desired outcomes.
Contact the Jupiter Supports Team
Contact us if you have questions about the referral process or need help completing the online form.