We will focus on helping you understand how Everyday Independence works, what services and support are available and build resources to help improve your participation and transparency across the process.

Fill out the form to make a referral and one of our team members will contact you shortly to discuss the next steps.

We also accept referrals in three other ways:

Call Us: 1300 179 131
Fax: (03) 5441 1490
referral@everydayind.com.au

  • 1. Client's Details -

    Client's Details

2. Referrer Details +

Referrer's Details

  • Any Risks or Issues?*

    * Are there any environmental, behavioural or other issues we should be aware of? If so please indicate below and we will contact you to discuss so we can provide therapy in a safe and supportive way.

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