Make a Referral – Empowering Connection

Make a referral

let's get started

Complete our referral form to help us understand the services and support that best fit your needs. You can refer yourself, or be referred by family, a support coordinator, a health professional or anyone who supports you.

What happens next

How referrals work

Send your referral

Fill in the form below, call us or email our team.

We'll be in touch

A member of our team will contact you to talk about your goals and needs.

Check your funding

We'll look at your NDIS plan with you.

Meet your team

We'll match you with the right people and agree a time to start.

Referral form

Tell us a little about yourself or the person you're referring, and a member of our team will be in touch. Not on the NDIS yet? Find out how to apply at ndis.gov.au.

Thanks for getting in touch!
Our team will contact you shortly.

Get in touch

Tell us a little about what you need and our team will be in touch.

Your name *

Please provide your name

Your postcode *

Please enter a valid 4-digit postcode

Your email address *

Please enter a valid email address e.g. name@email.com

Your phone number (optional)

What support are you looking for? * (tick one)

Please tick one

Which NDIS services are you interested in? (tick all that apply)

Message (optional)

We'll only use your details to respond to your enquiry.

Prefer to talk? Call 1800 716 824 or email enquiries@empoweringconnection.com.au

We’re here to help

Have a question before you refer? Our team is happy to help.

Call 1800 716 824

enquiries@empoweringconnection.com.au

Care and support from a local team across the Fleurieu Peninsula.

1800 716 824

enquiries@empoweringconnection.com.au

Head Office
96 Victoria Street, Victor Harbor, SA, 5211

Cafe and outreach
U6, 68–78 Victoria Street, Victor Harbor, SA, 5211

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Aged Care · Support at Home

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Empowering Connection acknowledges the Traditional Owners and Custodians of the lands on which we live and work, and their connection to land, sea and community. We pay our respects to Elders past and present.

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