Carer Referral - Different Journeys Autism

This is a place where you can directly refer a carer to us. Once referred, we will reach out and provide support with any services, questions or guidance that they may need.

To refer a carer to us, please fill out the form below.

Thank you for your interest in connecting with us. A member of our peer support team will be in touch soon, but please note that we are not a crisis service. If you need quicker support, we warmly invite you to join one of our carer events. These gatherings are wonderful opportunities to connect with others who share similar experiences.

Organisation Details

Organisation Name:

Your First Name:

Your Last Name:

Your Email:

Your Phone:

Carer Details

Carer's First Name:

Carer's Last Name:

Carer's Age:

Carer's Email:

Carer's Phone:

Carer's Address:

Full Name{s} of Carer's Recipient(s):

Age of Carer Recipient(s):

Carer’s Information/Background:

Reason for Referral (what support do they need):

Are there any current services that have been referred/involved? E.g. support coordinator

If Yes - Name of Service

Any Other Additional Information?

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