This referral form collects information to assist Avid Helthcare staff to help people get access to the NDIS services they may need.
By signing this form, I consent to be referred to Avid Healthcare, and give Avid Healthcare permission to contact my referrer/clinical supports. Avd Healthcare will contact my referrer/clinical supports to obtain information relevant to providing care and services to me. If this is a self-referral, I consent for my clinical
supports to be contacted and to obtain information relevant to providing care and services to me. I understand that I can withdraw from this referral or from the referred service at any time. All information will be treated confidentialy and will only be used for the purposes stated in this form.