Support Coordinator Referral

Support your NDIS participants with referrals to specialist ergonomic and mobility solutions.

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Professional Referral Form

Help us provide the best possible service to your participant by sharing relevant information about their needs.

👩‍💼 Support Coordinator Details

Your Name *

Job Title *

Organisation *

Phone Number *

Email Address *

👤 Participant Information

Participant First Name *

Participant Last Name *

Participant Email

Participant Phone *

NDIS Number *

Plan Management Type *

📍 Participant Location

Suburb *

State *

Postcode *

🎯 Referral Details

Reason for Referral *

Specific Needs and Requirements *
Describe relevant medical conditions, challenges, and desired outcomes...[/textarea]

Urgency Level *

Estimated Budget Range

📋 Additional Information

Other Professionals Involved

Additional Notes

Preferred Contact Method for Updates

✅ Consent and Privacy

I confirm that the participant has provided consent for this referral and for Bad Backs to contact them directly. * I consent to Bad Backs sharing relevant information about services provided with me as the referring support coordinator. * I acknowledge that all information will be handled in accordance with privacy legislation and professional standards. *

Please prove you are human by selecting the heart.

We'll contact the participant within 24 hours and keep you updated on progress.

Our Referral Process

Referral Received

We’ll acknowledge your referral within 2 hours so you know it’s in safe hands.

Participant Contact

Our team reaches out within 24 hours to arrange a friendly consultation and keep things moving quickly.

Assessment & Solutions

We carry out a thorough assessment and recommend tailored solutions backed by our specialist knowledge.

Keep You Informed

You’ll receive regular updates, so you’re never left wondering where things are at.

Resources for Support Coordinators

Practical tools and trusted information to help you guide your participants with confidence.

Product Guides

Clear, easy-to-follow guides on our products and how they fit within NDIS applications.

Download Guides →

Training Resources

Step-by-step learning materials covering ergonomics, mobility, and everyday solutions that make a difference.

Access Training →

Professional Support

Direct line to our specialist team, support coordinators and healthcare professionals get the answers they need, fast.

Contact Support →