Shepparton & the Goulburn Valley

enquiries@ftacare.com.au

Call 0497 951 282

Home
About Us
Services
Work With Us
Make a referral

Home
About Us
Services
Work With Us
Make a referral

FTA CARE · GOULBURN VALLEY

Make a referral

Start a conversation

You can refer yourself, a family member or someone you support. Complete the form below, or call us on 0497 951 282.

Make an enquiry

Call 0497 951 282

Illustrative stock photograph: a notebook and pen

Who is making this referral?

Choose the option that applies to you. Complete the details below and our team will be in touch. To share supporting documents, please contact us to arrange a suitable method.

1. About you

Your name

Phone

Best way to contact you

Phone Email

Date of birth

Suburb

NDIS number (leave blank for aged care)

How is your plan managed?

2. Support needed

Which service?

What support do you need?

Anything we should know before we make contact?

How soon is support needed?

Within a week Within a month Just asking for now

3. Consent

Consent

I agree to share my details with FTA Care for this referral.

Privacy

I understand that this form will email the details I provide to FTA Care to assess and respond to this referral. Privacy information.

1. About you

I am a

Your name

Organisation (if any)

Phone

Best way to contact you

Phone Email

2. About the person being referred

Person being referred — full name

Date of birth

Suburb

Their phone

NDIS number (leave blank for aged care)

How is their plan managed?

3. Support needed

Which service?

What support do they need?

Anything we should know before we make contact?

How soon is support needed?

Within a week Within a month Just asking for now

4. Consent

Consent

The person being referred (or their guardian) agrees to their details being shared with FTA Care.

Privacy

I understand that this form will email the details I provide to FTA Care to assess and respond to this referral. Privacy information.

Rather talk? Call 0497 951 282. If someone is in immediate danger, call 000.

FTA Care

Trust, care and we listen.

Local disability and aged care support across Shepparton and the Goulburn Valley.

Make a referral

Our services

Supported Independent Living (SIL)

High-Intensity and Complex Support

In-Home Support / Daily Living

Community Access

Justice, Court and Family Support

Aged Care – Support at Home

Useful links

Feedback & complaints

Get in touch

0497 951 282

Email our team

enquiries@ftacare.com.au

Where we support

Shepparton · Mooroopna · Kialla · The wider Goulburn Valley

Acknowledgement of Country

FTA Care acknowledges the Yorta Yorta people, the Traditional Owners of the land on which we live and work, and pays respect to Elders past and present.

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