Enquiry Form

Please note - Completion of our Enquiry form will help determine if Reframe is a good fit for you or someone you are supporting.

Client Details

Date *

Name *

Location (Suburb and State) *

Age *

Preferred Mode: *

In PersonOnlineFlexible

Please note: In-person services not available in QLD.

Cultural Considerations

Please provide relevant background information and what services you require *

Funding Category *

I'm paying myselfNDISLifetime CareCTP

CTP Provider *

CTP Billing email address *

CTP Client Claim Number *

Please note: Reframe Careers currently works with Self or Plan Managed NDIS Clients only.

We can claim from the funding categories: Finding and Keeping A Job [FAKAJ] & Improved Daily Living [IDL].

Please ensure there is a minimum of 12 hours funding available for employment related counselling/assessment (plus travel time and km if face-to-face services are requested).

I confirm that there is 12 hours funding in FAKAJ or IDL (plus travel time and km if needing face-to-face) for initial assessment? *

YesNo

Do you have an NDIS Goal that relates to employment? *

YesNo

Summary of the NDIS Goal relating to employment *

Do you have current NDIS funding (in either FAKAJ or IDL) that could support follow up services after initial assessment? *

YesNo

Please specify the primary disability/diagnosis *

Do you or the person you're supporting identify as having a psychosocial disability (e.g. a mental health condition such as anxiety, depression, bipolar, schizophrenia, etc.)? *

Yes – specifically psychosocial disabilityYes – but another type of disabilityNo

Are there psychosocial factors (e.g., housing, substance misuse, mental health) that should be taken into account with the injury treated under LTC? *

YesNo

Are there psychosocial factors (e.g., housing, substance misuse, mental health) that should be taken into account with the injury treated under CTP? *

YesNo

If yes, please specify the condition or impact *

Are there any behaviours of concern? *

YesNo

Please elaborate *

Lifetime Care Service required *

Initial AssessmentVocational Services / CounsellingUnsure - need to discuss further

Other *

Any documents that may support this enquiry?

Browse

Enquirer Name *

Enquirer Phone Number

Enquirer Email *

The Enquirer gives consent to go onto the Reframe mailing list for updates about services, new team members and capacity

If Other, please let us know! *

Director Review

This Person is suitable for services *

YesNoNeed further info

Please describe the further information required from referrer *Please be aware this text is sent to the referrer on the workflow email

If No, please specify reason for decline *Please be aware this text is sent to the Referrer/Client/Client representative

Any further information for the Counsellor?

Allocated Counsellor *

Counsellor Email *

Once received, please upload further info, if required

Browse

IF REQUIRED - THIS UPLOAD SPOT IS ONLY REQUIRED THROUGH THE "NEEDS FURTHER INFO" FORM LOOP

ONLY AFTER FURTHER INFO RECEIVED please copy paste the further info, if requiredIF REQUIRED - THIS FIELD IS ONLY REQUIRED THROUGH THE "NEEDS FURTHER INFO" FORM LOOP

ONLY AFTER FURTHER INFO RECEIVED: Please reply to the Enquirer using this box here (is included in workflow Accept yes email), if requiredIF REQUIRED - THIS FIELD IS ONLY REQUIRED THROUGH THE "NEEDS FURTHER INFO" FORM LOOP - THIS INFO GOES TO THE ENQUIRER ON THE AUTO WORKFLOW ACCEPT YES EMAIL

Counsellor Review

Please note: this enquiry is not a guaranteed conversion to referral

I accept this referral *

YesNoAdmin Reset

Please do not select Admin Reset unless you are Admin

Currently, more funds ARE available for this Client after the 12h initial is spent.

Please note NO more funds are available for this Client after the 12h initial is spent. Please be conservative.

If No, please specify reason for decline *Please be aware this text is sent to the Enquirer/Client/Client representative

Client current location

Please advise how much travel time you will need to visit this Client in person *

Director to Review

This Person is suitable for services *

YesNo

If No, please specify reason for decline *Please be aware this text is sent to the Referrer/Client/Client representative

Allocated Counsellor *

Counsellor Email *

Counsellor to Review

Please note: this enquiry is not a guaranteed conversion to referral

I accept this referral *

YesNo

If No, please specify reason for decline *Please be aware this text is sent to the Referrer/Client/Client representative

Client current location

Please advise how much travel time you will need to visit this Client in person *

Final Review by Director

This Person is suitable for services *

NoWaitlist

If No, please specify reason for decline *Please be aware this text is sent to the Enquirer/Client/Client representative

Waitlist info for Enquirer *Please be aware this text is sent to the Enquirer/Client/Client representative

Please provide waitlist info for Admin *

Director Finalisation

This Client has already had their Calendly Initial Call

This Client is suitable for full Referral *

This LTCS Client is Suitable for Accept & Send Quote

This CTP Client is Suitable for Accept & Send Quote

This is a specific Jane allocation - and this Client is to be waitlisted

This Client is for the Team Waitlist

This is a PRIVATE Client setup

The following is sent on the auto fleeced workflow emails from SnapForms:

Reframe says YES to your enquiry
“Any other info for inclusion” as per whatever you add into text box below
Supplied the initial Jane call Calendly link (if hasn't already had call)

ADMIN will now:

Setup in Case Manager & Asana
No estimate setup or T&C sent as yet (until Referral completed)
Follow up with Client/Rep if initial Jane call not booked in the next 2 weeks
Once the call is booked, Calendly will send the link tofull Referral (using the Private selection)
Follow up with Client/Rep 1 week AFTER call date if Referral not received

If there are any other instructions, please enter them in the “other Admin info” below:

Please send this NDIS Client my Calendly booking link

This is an NDIS Client setup

The following is sent on the auto fleeced workflow emails from SnapForms:

Reframe says YES to your enquiry
“Any other info for inclusion” as per whatever you add into text box below
Supplied the link to full Referral (using the NDIS selection)
Supplied the initial Jane call Calendly link - if you checked the box to indicate you approved this

ADMIN will now:

Setup in Case Manager & Asana
No estimate setup or SA sent as yet (until Referral completed)
Follow up with Enquirer/Client/Rep if full Referral not received in the next 2 weeks

If there are any other instructions, please enter them in the “Other Admin Info” box below:

This is an LTCS Client setup

The following is sent on the auto fleeced workflow emails from SnapForms:

Reframe says YES to your enquiry
States whom their allocated Counsellor is
Includes the Quotation table as per the hours requested in the “LTCS Quote” section
Stipulation to send all relevant reports and the funding approval to Admin
“Any other info for inclusion” as per whatever you add into text box below
If you would like to discuss further, please contact Annie

ADMIN will now:

Setup in Case Manager & Asana
Estimate setup as per Quote
Follow up with Claims Office if Approval and/or other docs not received in the next 2 weeks
Once Approval is received, Admin will send T&C form and alert Counsellor to contact Client

If there are any other instructions, please enter them in the “Other Admin Info” box below:

This is an CTP Client setup

The following is sent on the auto fleeced workflow emails from SnapForms:

Reframe says YES to your enquiry
States whom their allocated Counsellor is
Includes the Quotation table as per the hours requested in the “CTP Quote” section
SENDS THE QUOTE TO THE CTP PROVIDER DIRECTLY with CC: ENQUIRER
Stipulation to send all relevant reports and the funding approval to Admin
“Any other info for inclusion” as per whatever you add into text box below
If you would like to discuss further, please contact Annie

ADMIN will now:

Setup in Case Manager & Asana
Estimate setup as per Quote
Follow up with Claims Office if Approval and/or other docs not received in the next 2 weeks
Once Approval is received, Admin will send T&C form and alert Counsellor to contact Client

If there are any other instructions, please enter them in the “Other Admin Info” box below:

Any other info for inclusion on the automatic fleeced workflow email to the enquirer?Please be aware this text is sent to the Referrer/Client/Client representative

Any notes for Admin?

LTCS Quote

Fill in the HOURS and the RATE (Jane - if it's you, it's $253)

Choose the relevant line item *

Hours required *

Rate *

Total $ incl GST

Initial Assessment - LTCS289 is always 4 hours plus travel

Rationale for line item 1 *

I need another line item included

Choose a second line item required *

Hours required *

Rate *

2nd line - Total $ incl GST

Rationale for line item 2 *

Reports & Plans

Report hours required *

Rate *

Report total $ incl GST

Travel

Travel hours required *

Rate *

Travel total $ incl GST

Total cost of Quote

CTP Quote

Fill in the HOURS and the RATE (Jane - if it's you, it's $253)

CTP Choose the relevant line item *

Hours required *

Rate *

Total $ incl GST

Reports & Plans

Report hours required *

Rate *

Report total $ incl GST

Travel

Travel hours required *

Rate *

Travel total $ incl GST

CTP Total cost of quote

Admin Actions

Please review any attached documents for other info and enter as much data as you have available into CM/Asana

Client setup in Case Manager: + New Case > Next

1st Page - Contact: Name & Address

1st Page - scroll down - Other Details: Gender & Birth date *if known*

2nd Page - Case: Category (funding source)

2nd Page - Case:
Leave Case no empty - this is the default CM internal numbering
Add - Claim no

2nd Page - Case: Status (Pending Referral (Enquiry Accepted))

2nd Page - Case: Status (Pending Documents) *this refers to LTCS Quote

2nd Page - Case: Biller code (FAKAJ or IDL funding) *if known*

2nd Page - Case: Emp status (funding division)

2nd Page - Case: Condition (diagnoses)

2nd Page - Case: Flag - Unsigned Service Agreement

2nd Page - Case: Flag - Unsigned Terms & Conditions

2nd Page - Case: Flag - Awaiting Quote Approval

2nd Page - Case: Flag notes (NDIS plan dates *if known* & reason for referral)

2nd Page - Allocation: Assigned To (add Counsellor!!!)

2nd page - Allocation: Assigned to is "Annie" if allocation is TBC or Team Waitlist

CM Tab - Contacts: Add Representative, Referrer, Support Coordinator/Claims Officer

CM Tab - Contacts: Add Bill To - search for "Accounts" - scroll down - Role: Bill-to
If adding a new contact - Company, First name: Accounts, Email 1: billing email, Position: Plan Manager

This Client has had Jane's Calendly link sent to them automatically through SnapForms

Private Client - do not attend setup of CM Estimate or sending Terms & Conditions form until Referral received

All Private Clients need initial Jane call booked!Create follow up task in Asana to contact Client if initial Jane call not booked in the next 2 weeks (the actual meeting date may be weeks in advance but we're chasing if the call has been booked ONLY). Create follow up task in Asana to contact Client - 1 week after "Post Initial Call Form" is sent for Referral (create now just don't give due date yet, and then each week for 4 weeks)Add "Waiting on T&C" to Client task name

NDIS ACTIVE Client - do not attend setup of CM Estimate or sending Service Agreement form until Referral received

1. Create follow up task in Asana to contact Client/Rep/Ref if Referral not received in 2 weeks2. Add "Waiting on Referral" to Client task name3. Double check if Jane has sent her Calendly link - follow up in 2 weeks with the Client about this if so4. Create Asana subtask "after Referral accepted to follow up for supporting documents"5. Create Asana subtask "when SSA is received, upload supporting docs to Everbility"

NDIS WAITLISTED - do not attend setup of CM Estimate or sending Service Agreement form until Referral received

1. Create follow up task in Asana to "contact Jane regarding spot on Waitlist and send Referral form" each 3-4 weeks (or if Jane has given a specific date, time the task to be so the Referral is received before services commence)2. Add "Waitlisted" to Client task name & Add "Waiting on Referral" to Client task name3. Double check if Jane has sent her Calendly link - follow up in 2 weeks with the Client about this if so4. Create Asana subtask "after Referral accepted to follow up for supporting documents"5. Create Asana subtask "when SSA is received, upload supporting docs to Everbility"

JANE NDIS WAITLISTED Client - do not attend setup of CM Estimate or sending Service Agreement form until Referral received

1. Create follow up task in Asana to "contact Jane regarding spot on Waitlist and send Referral form" each 3-4 weeks (or if Jane has given a specific date, time the task to be so the Referral is received before services commence)2. Add "Waitlisted" to Client task name & Add "Waiting on Referral" to Client task name3. Double check if Jane has sent her Calendly link - follow up in 2 weeks with the Client about this if so4. Create Asana subtask "after Referral accepted to follow up for supporting documents"5. Create Asana subtask "when SSA is received, upload supporting docs to Everbility"

This Client can only be seen for the 12h + travel +km. The Referrer has said that there are NO additional funds after initial assessment. Please create an Asana subtask to remind the allocated RC of this when SSA received.

LTCS Client - do not attend sending Terms & Conditions form until Quote has been approved

Double check any MyPlan documentation for additional info like Claim No/DOB etcSetup CM Estimate as per the Quote informationCreate follow up task in Asana each 2 weeks to "contact the Claims Officer for Approval document and/or any supporting documentation"Create follow up task in Asana for "when Service Approval is received, to update Estimate and send the Lifetime Care T&C"Create follow up task in Asana for "after Service Approval is received - follow up for supporting documents" using CM email templateCreate follow up task in Asana for "when Signed T&C received, upload supporting docs to Everbility"Add "Waiting on Quote Approval" to Client task name

CTP Client - do not attend sending Terms & Conditions form until Quote has been approved

Double check any documentation for additional info like Claim No/DOB etcADD THE BILL TO AS PER THE CPD PROVIDER BILLING EMAIL ADDRESSSetup CM Estimate as per the Quote informationCreate follow up task in Asana each 2 weeks to "contact the Claims Officer for Approval document and/or any supporting documentation"Create follow up task in Asana for "when Service Approval is received, to update Estimate and send the CTP T&C"Create follow up task in Asana for "after Service Approval is received - follow up for supporting documents" using CM email templateCreate follow up task in Asana for "when Signed T&C received, upload supporting docs to Everbility"Add "Waiting on Quote Approval" to Client task name

THE CLIENT'S QUOTE IS SENT AUTOMATICALLY THROUGH FLEECED WORKFLOW EMAILS

Admin@ will be sent a copy, upload this to CM

Client setup in Asana

Set up Client in Asana

Add all relevant tags to Client profile in Asana

Upload any emails, documents and this completed Referral PDF to CM when they come through to admin@ post completion

THIS CLIENT IS WAITLISTED - ensure this is reflected in CM
In Asana, keep Client task in Enquiry Section but ensure you label "Waitlisted" next to name

Admin completing this Form *

Save and Complete Later