Name: Southern Star Care
Address: Suite 20, Springvale Road, Mulgrave, VIC, 799, AU
Telephone: (03) 7022 6778
Price range: $

Southern Star Care Intake Form

Please fill our the form below, and a member of our team will contact you!

Date

Full Name*

NDIS Number*

Date of Birth*

Address*

Gender*

Photo Upload Please upload a clear, unedited and recent photo of the participant, so we can use this for their profile and person-centred plan. This photo should capture them from their torso and above

Contact Name*

Contact Number*

Email Address*

Disability Diagnosis*

Service Inquiry*

Behaviours/Triggers/Dislikes*

Does the Participant have a Support Coordinator?*

Plan Management*

NDIS Plan Upload Or screenshot of funding/budget

Allied Health Document Upload Please include relevant Allied Health Reports (Physio, Speech, OT)

Are there any Behaviours of Concern?*

Referrer Full Name

Referrer Contact Number

Referrer Email

Referrer Company Name

Service Commencement

Testimonials

    
 
 
       Posted on Google  
   
   Rajitha Ratnayake 
 
 
 
 Trustindex verifies that the original source of the review is Google. Southern Star Service has been incredibly supportive and professional. Their team communicates clearly, responds quickly, and genuinely cares about each participant’s wellbeing.
  
 
      Posted on Google  
   
   Geeksonfleek bakkali 
 
 
 
 Trustindex verifies that the original source of the review is Google. Great service and amazing professionalism. Highly recommend!
  
 
      Posted on Google  
   
   Brandon Salama 
 
 
 
 Trustindex verifies that the original source of the review is Google. Southern Staff Care have been fantastic to work with. Their team is professional, reliable and genuinely committed to quality care. Communication is always clear and timely, which makes everything smoother. Highly recommend 💫
  
 
      Posted on Google  
   
   Amanda Samoa 
 
 
 
 Trustindex verifies that the original source of the review is Google. Amazing service and very participant focused. Would highly recommend
  
 
      Posted on Google  
   
   Seshan Ramaswamy 
 
 
 
 Trustindex verifies that the original source of the review is Google. Trustworthy and reliable service provider, and great leadership team led by Joseph. Would highly recommend!
  
 
      Posted on Google  
   
   Andy Agutu 
 
 
 
 Trustindex verifies that the original source of the review is Google. The professionalism of the management and staff was beyond the roof. I highly recommend.👏
  
 
      Posted on Google  
   
   Cameron Johns 
 
 
 
 Trustindex verifies that the original source of the review is Google. Southern Star Care has been a very supportive and caring company. Looking after participants and staff to better all