Submit a referral

Complete the form below with the participant's details, background, and support needs, and The Lifeskills Lab will be in touch to discuss next steps.

Before you begin

This form collects personal and health information needed to review a referral. Fields marked * are required. Please only provide information that is relevant to the referral and that you are authorised to share. Please read our Privacy Policy before submitting.

Participant details

Participant name *

Residential address

Cultural background / ethnicity

Kindergarten / school / childcare centre

Grade / year level

Person making the referral

Referrer name *

Relationship to participant

Contact details

Email *

Phone

Parent / guardian details

Parent / guardian details are the same as the person completing this referral

Parent / guardian name *

Parent / guardian email *

Parent / guardian phone

About the participant

Reason for referral *

Max 2000 characters

Background information *

Max 2000 characters

Support needs *

Max 2000 characters

NDIS details

NDIS number

Plan dates

Funding type

Plan manager / billing contact

Privacy and collection notice

The Lifeskills Lab collects the personal and health information in this form to assess and respond to the referral, contact relevant people, plan services, administer funding, and meet legal or professional obligations. If required information is not provided, we may be unable to assess the referral. Information may be disclosed where reasonably necessary to people involved in care or administration, or where required or authorised by law. By submitting, you confirm that you are authorised to provide this information. Read our Privacy Policy for information about access, correction, complaints, and how personal information is handled.

I have read and agree to the Privacy Policy. *

Questions?

For general enquiries, email us and we will respond as soon as possible.

hello@thelifeskillslab.com.au

What happens next?

Your referral is reviewed and acknowledged by email.
We talk through goals, funding, and availability.
An initial assessment is scheduled at a time that suits you.