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Contact and Enquiry, Continuum Teletherapy and Allied Health
Whether you are a patient, carer, support coordinator, or just have a question, this is the right place to start. This form takes about 3 minutes. We will be in touch within
1 to 2 business days
.
Have a question first?
Visit our FAQ
.
Who are you?
*
A
Patient or family member
B
NDIS participant or support coordinator
C
Health professional or clinician
D
Aged care or disability organisation
E
General enquiry
About You
First Name
*
Last Name
*
Date of Birth
*
Email Address
*
Phone Number
*
Which State Are You In?
*
Are you referring yourself, or someone else?
*
A
Myself
B
Someone else (family member, person I care for)
About Your Care Needs
Services You're Interested In
Our NDIS registration covers Therapeutic Supports only, which for us means psychology and dietetics. Oral health is a private service and is not funded by the NDIS.
*
How Are You Funding Your Care?
Not sure?
See our NDIS and Funding FAQ
. Continuum Health Group Pty Ltd is a registered NDIS provider (Registration ID 4-M39ECWP) for Therapeutic Supports, which covers our psychology and dietetics for participants aged 18 and over. Oral health consultations are private pay and are not funded by the NDIS. We can see agency managed, plan managed and self managed participants.
*
A
NDIS, self managed
B
NDIS, plan managed
C
NDIS, agency managed
D
Private / self-funded
E
Medicare (if eligible)
F
Not sure
Tell Us About Your Situation
*
Do You Have a GP or Current Treating Doctor?
*
A
Yes
B
No
Do You Have a Support Coordinator, Carer, or Guardian?
*
A
Yes
B
No
Support Coordinator / Carer Name
Support Coordinator / Carer Contact
How Did You Hear About Us?
*
Consent and Privacy
Your information will be handled in accordance with the Australian Privacy Principles and our
Privacy Policy
. By submitting this form, you consent to Continuum Teletherapy and Allied Health contacting you to discuss your enquiry and eligibility for services.
I consent to being contacted by Continuum Teletherapy and Allied Health
I confirm the information provided is accurate to the best of my knowledge
Submit Referral
