Autism Inclusion Practitioner Request for Service

Please complete this document when referring for Autism Inclusion Practitioner Support.

Autism Inclusion Support is tailored therapeutic support provided by our team of highly skilled allied health professionals designed to empower autistic school aged children  within their learning environment.

Practitioner support is typically delivered within school hours in the learning environment (school or home) and may include 1:1 skill building in line with the students NDIS goals, the development of personalised learning resources, individualised programming, attendance in meetings or the creation of therapy programs to help your child apply their skills outside of a structured therapy environment.

If you require any support in completing this form, please contact us on 08 8379 6976.

REFERRAL INFORMATION
CLIENT INFORMATION
AUTISM INCLUSION PRACTITIONER BOOKING PREFERENCES

Upon receipt of the completed referral form, unless we need to discuss any of your responses with you first, our Client Relationship Team will develop a Service Agreement for you based on the answers you provide.  These are typically blocks of 24 hours and Autism Inclusion Practitioner sessions. Please note that session times are booked in 1.5 hour sessions with a mixture of face-to-face and non face-to face components. The agreement will be sent for your approval, and once approved you will be ready to be offered a suitable vacancy when it arises. 
 

Please provide the below information to assist us in creating your agreement.

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BLOCK OF SUPPORT
LOCATION:
Thank you for completing this referral form to support in the allocation of Autism Inclusion Practitioner Services.