Make a Referral

Refer someone for adult support services

Use this form to share referral details. A member of the APS team will review the information and contact you to discuss the next steps.

Referral planning
1. Share Details

Tell us about the person, their current situation, support needs and desired outcomes.

2. Review & Clarify

We review the information and contact the referrer to discuss suitability and next steps.

3. Plan Support

Where appropriate, we agree support goals, risks, boundaries and review arrangements.

Referrer Details

Person Being Referred

Service Requested

This helps protect Assured People Support from spam and automated submissions.

Please do not use this form for emergencies. If someone is at immediate risk of harm, contact emergency services or the appropriate crisis service.

What information helps us review a referral?

  • Current situation and reason for referral
  • Known risks, triggers and early warning signs
  • Communication preferences and support needs
  • Desired outcomes and priority goals
  • Professionals or family members involved

Secure Referral Notice

Please only share information that is relevant to the referral. Referral information should be handled carefully and reviewed by the appropriate APS team member before support begins.