Referral Form
Refer a Client for Continence Support

At Caremmunity, we make it easy for Support Coordinators, carers, families, and allied health professionals to refer clients for continence assessments, product supply, and ongoing care. Our referral process is quick, easy, and supportive .

Refer a client Through a home care package
Refer a Client for Continence Support

At Caremmunity, we’re here to make referring a client for continence support as easy and stress-free as possible. Whether you’re a Support Coordinator, Plan Manager, carer, family member, or allied health professional, we’re ready to help.

If you know someone who could benefit from a continence assessment, ongoing care, or help accessing the right continence products, simply complete the referral form below. Whether they’re an NDIS participant, a Home Care Package client, or someone needing a little extra support, we’ll take it from there.

Our referral process is quick, easy, and supportive — and you can trust us to guide the client (and you) every step of the way.

How It Works

  1. Fill out the referral form below with as much information as you can. There 4 simple sections to complete.

  2. Our friendly team will contact the client (or their representative) within 1–2 business days.

  3. We’ll arrange everything — from continence assessments and management plans to product supply and funding paperwork support.

  4. We’ll also keep you in the loop, so you always know what’s happening.

If you have any questions before referring, or just want a little extra guidance, please don’t hesitate to get in touchwe’re always happy to help.

Step 1 - Contact Information


Participant's Contact Details
Type of Funding
NDIS Plan Information

** payment will be required prior to the assessment

Referrer Contact Details
Please take the time to provide 2 mores important contacts.
  1. Who we CALL to confirm the booking time when the client and representative are available
  2. The representative attending contact, when required who is going to be available to help with history and assessment questions at the time of assessment.
Best contact for us to book the assessment date and time?

Client, Clients Representative, SIL Manager, Team Leader, Diary Manager

Representative Attending the Assessment with the Participant

Support Worker, Clients Representative, SIL Manager, Team Leader

Step 2 - The Service Request


Service Requests and Supports

Step 3 - Accompanying Information

The availability of the following documents for our attending nurses will help us priorities your referral.

Please Attach Your Document

Step 4 - Potential Hazards