Make a referral

Referral form

Fields marked * are required.

About you
Consent
Who agreed to this referral? (required)
About the participant
Age range (required)
Who should we contact first? (required)

For participants under 18, we contact their parent or guardian first.

Their preferred way to be contacted
Interests
Interested in
Preferred times
Funding
How is the participant funded? (required)

Anything else

For example: text first, a support person present, AAC (a communication device or app), or an interpreter and which language. Please don't include a diagnosis.

Please don't include the participant's NDIS number, diagnosis or plan details. We'll collect what we need securely at intake.

CH3CKPOINT PTY LTD collects these details to respond to this referral, contact the person you name and check whether our services suit the participant. When you press Send referral, the form passes through our website host (Vercel) and arrives as an email in our Microsoft 365 inbox, info@ch3ckpoint.com.au. Our website does not keep a copy. Only CH3CKPOINT staff who handle referrals can read it. We do not share it with anyone else unless the participant (or their parent or guardian) agrees or the law requires it, and we never sell it. Vercel and Microsoft may process or store it outside Australia, including in the United States. If required details are missing, we may not be able to respond. When we first contact the participant, we will tell them we have their details and who gave them to us. You or the participant can ask to see or correct this information by emailing info@ch3ckpoint.com.au. Our Privacy Policy explains how we handle personal information and how to make a complaint.

Ready to refer? Or just want to know more?

We're accepting referrals now. Contact us to check availability, ask questions about billing, book a 15-minute info call for families, or register interest for a hub tour. Every new participant can try one free social session, at no cost to you or your plan, and you do not have to sign up to anything afterwards. Hub tours and free trial social sessions will start shortly before our first program sessions. We will contact you with dates.

Email info@ch3ckpoint.com.au or call 0435 759 867

Deaf, hard of hearing or speech impaired? Contact us through the National Relay Service (accesshub.gov.au) and give our number.

  • Self-managed and plan-managed
  • No gap fees
  • We reply within 2 business days

When you email us, we collect your contact details and anything you tell us, so we can answer you. Our email runs on Microsoft 365, which may store it outside Australia, including in the United States. If you're writing about someone else, please check they (or their parent or guardian) agree, and don't include NDIS numbers or health details until we ask. Read our Privacy Policy. To give feedback or make a complaint, see Complaints and Feedback.