If you know someone who would benefit from assistance or would like to refer yourself, please complete one of our referral forms.

How do I refer a someone for care?

If you know someone who is 65 or older and would benefit from assistance at home, please complete the Aged Care Support Referral form. Or if you know someone who is under 65 and requires disability support services, please complete the Disability Support Services Referral form.

You can complete the form online or download the PDF version* and email the completed PDF form to

*Ensure that you open the PDF form separately in acrobat reader, you can download acrobat reader for free here.

Aged Care Support Referral Form

 A Benevolent society staff member with an older Australian 


Complete the form online 

Download the PDF version


Disability Support Services Referral Form 

 A benevolent society staff member with a client

Complete the form online

Download the PDF version