Intake Referral Form

Date *

Just So You Know - “Client” = You

When we say “Client” in this form, we’re talking about the person requiring supports from Reframe.

Client Details

First Name *

Last Name *

Date of Birth *

Gender *

Female MaleOther / Non Binary

Pronouns

Email *

Phone Number *

Address

Cultural Considerations

Does the Client have an Authorised Representative? *

YesNo

Contact for arranging initial appointment *

Client Representative / Next of Kin

First Name *

Last Name

Relationship to Client *

if Other, please specify: *

Contact Phone Number

Contact Email

Referrer Details

I am self-referred

First Name *

Last Name *

Referral Organisation

Referrer Type *

If Other, please specify: *

Referrer Phone *

Referrer Email *

The person being referred has given consent to this referral and consents to these details being kept on a cloud based case management system *

The Referrer gives consent to go onto the Reframe mailing list for updates about services, new counsellors and capacity

Funding Information

How will your sessions be paid for? *

I'm paying myselfNDIS - Self or Plan managed

Please specify your current position *

School Student or Early CareerMid-Late Career

Reframe provides personalised career counselling for students and young people to help them explore their strengths, understand career options, and plan future pathways.

Sessions are available online or in person, with optional Morrisby career profiling for deeper career insights.

All fees can be found on our website - or we may negotiate private counselling sessions ongoing with you.

Click here to go through to our e-shop (Fees include GST and time for preparation and follow-up.)

Reframe supports mid- to late-career professionals who are looking to transition into new career pathways.

Through a structured four-stage process, clients assess their current situation, identify strengths and transferable skills, explore meaningful career options, and develop strong job-seeking strategies including applications, online presence, and interview coaching.

Services are tailored to individual needs, with options to purchase stages individually or as a discounted total package.

All fees can be found on our website - or we may negotiate private counselling sessions ongoing with you.

Click here to go through to our e-shop (Fees include GST and time for preparation and follow-up.)

Please confirm that you have availability to fund a minimum of 12 hours (plus travel time and km if face-to-face services are requested) to complete the Employment-Related Assessment process.

Employment-Related Counselling and Assessment

An Employment-Related Assessment is a structure process designed Reframe Careers to help NDIS Clients identify their strengths, skills, interests, challenges, and goals. This support aims to create a clear, practical pathway toward employment, education, or volunteering.

The Assessment process typically includes:

Self-Exploration: Gaining an understanding of strengths, skills, interests, work preferences and work capacity.
Identifying Barriers: Identifying challenges or obstacles that may impact employment opportunities.
Liaison with Treating Therapists and Stakeholders: Collaborating with support teams to ensure a comprehensive approach.
Readiness Assessment: Assessing readiness for paid employment and engaging in discussions about potential capacity-building activities.
Possible Pathways Brainstorm: Generating ideas relating to courses, specific jobs or self-employment pathways.
Goal Setting: Working collaboratively to establish short-term and long-term vocational goals.
Support Planning: Recommendations including strategies and additional supports to help achieve work, study, or volunteering goals.

This personalised approach ensures that Clients receive tailored support aligned with their unique needs and aspirations. Reframe Careers can adapt this process to individuals with a diverse range of disabilities, chronic health conditions, or injuries. It remains flexible enough to support those seeking entry-level roles as well as individuals pursuing professional careers.

Session rates:

As per the National Disability Insurance Scheme Act 2013 (Cth) - the Session rates are:

Within the applicable price limits set under the Act and the NDIS Pricing Arrangements and Price Limits ("NDIS Price Guide"); and
Reviewed and increased in accordance with any changes to the NDIS Price Guide and you will receive prior notice of any increases in the Support Fee.

Employment-Related Counselling:

Employment Related Allied Health Supports
Category - Capacity Building	Support Item Number	Support Item Name	Price per hour
Finding & Keeping A Job	10_011_0128_5_3	Employment Related Assessment, Counselling and Advice - Other Professional - SERVICE	$193.99
Finding & Keeping A Job	10_011_0128_5_3	Employment Related Assessment, Counselling and Advice - Other Professional - TRAVEL	$97.00
Finding & Keeping A Job	10_799_0128_5_3	Provider travel - non-labour costs	$1.00 per km
Finding & Keeping A Job	10_620_0128_5_3	Employment Related Assessment, Counselling and Advice - Rehabilitation Counsellor - SERVICE	$193.99
Finding & Keeping A Job	10_620_0128_5_3	Employment Related Assessment, Counselling and Advice - Rehabilitation Counsellor - TRAVEL	$97.00
Finding & Keeping A Job	10_799_0128_5_3	Provider travel - non-labour costs	$1.00 per km
Improved Daily Living	15_620_0128_1_3	Assessment Recommendation Therapy or Training - Rehabilitation Counsellor - SERVICE	$193.99
Improved Daily Living	15_620_0128_1_3	Assessment Recommendation Therapy or Training - Rehabilitation Counsellor - TRAVEL	$97.00
Improved Daily Living	15_799_0128_1_3	Provider travel - non-labour costs	$1.00 per km
Improved Daily Living	15_056_0128_1_3	Assessment Recommendation Therapy or Training - Other Professional - SERVICE	$193.99
Improved Daily Living	15_056_0128_1_3	Assessment Recommendation Therapy or Training - Other Professional - TRAVEL	$97.00
Improved Daily Living	15_799_0128_1_3	Provider travel - non-labour costs	$1.00 per km

Employment Services:

Reframe reserves the right to negotiate fees with Self-Managed Clients regarding the following Employment Services line items. Plan Managed Clients fees remain in line with the NDIS Price Guide.

Employment Support Supports
Category - Capacity Building	Support Item Number	Support Item Name	Plan Managed - Price per hour
Finding & Keeping A Job	10_016_0102_5_3	Employment Assistance - SERVICE	$80.06
Finding & Keeping A Job	10_016_0102_5_3	Employment Assistance - TRAVEL	$40.03
Finding & Keeping A Job	10_799_0102_5_3	Provider travel - non-labour costs	$1.00 per km
Improved Daily Living	15_053_0128_1_3	Therapy Assistant - Level 2 - SERVICE	$86.79
Improved Daily Living	15_053_0128_1_3	Therapy Assistant - Level 2 - TRAVEL	$43.40
Improved Daily Living	15_799_0128_1_3	Provider travel - non-labour costs	$1.00 per km

Please note that travel kilometres may be charged at the NDIS Price Guide rate of $1.00 per km travelled from the Counsellor's base of business to and or from your location. This is in addition to the time travelled.

NDIS Number *

Start of Plan *

End of Plan *

Line item required *

Capacity Building - Finding & Keeping a Job [FAKAJ]Capacity Building - Improved Daily Living [IDL]

Funds Management *

Billing email address *

Is a Report required for a Plan Review *

YesNo

Has this Plan been received on or after 19 May 2025? *

YesNo

With the introduction of funding periods and components in NDIS Plans, we now require confirmation of the Employment-Related Counselling/ Vocational Counselling/ Career Rehabilitation hours available for each funding period. This helps us align our services with the NDIS Plan's structure and ensures continuity of support.

Any unused hours within a funding period will automatically roll over and apply to the next funding period to ensure continuation of services.

Please advise of the time period of the funding brackets provided, along with the maximum hours available to Reframe Careers in each funding period - we bill from "Rehabilitation Counsellor" or "Other Professional" line items, as per the tables above.

Eg: Period 1: dd.mm.yy - dd.mm.yy - 10h available for services, Period 2: dd.mm.yy - dd.mm.yy - 8h available for services, etc *

Please advise of the maximum hours available to Reframe Careers in the current NDIS Plan (and specific line items if known) - we bill from "Rehabilitation Counsellor" or "Other Professional" line items, as per the tables above. *

It is essential that we review a copy of your current NDIS Plan

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This is so we can double check your funding categories to ensure we can provide support to you

There is availability to fund a minimum of 12 hours (plus travel time and km if face-to-face services are requested) to complete the Employment-Related Assessment process. *

What current NDIS funding is available (in either FAKAJ or IDL) that could be used to implement any recommendations made in the assessment phase? *

Send Service Agreement to *

Send Terms & Conditions to *

Any other Stakeholders involved in care

Referral Reason

Please provide the NDIS Goal/s that directly relate to Employment services *

Other - please state the situation

Are there any other important things you believe we need to know to work effectively with the Client? *

Are there any behaviours of concern? *

YesNo

Please elaborate *

Please upload forensic history information or behaviour support plan

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Preferred Mode: *

In PersonOnlineFlexible

Primary diagnosis *

If Other, please specify *

Secondary diagnosis

If Other, please specify

With consent, please provide any supporting letters, reports or other documentation

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Safety

Client and Staff Safety

If there are any safety concerns identified, Reframe Careers will, at the commencement of supports, work with the Client to identify any risks that may affect them, our staff or others. The Client will cooperate with all reasonable actions to minimise negative risk and enhance positive opportunities.
If supports are being provided within the Client's home, they agree to:

Allow Reframe Careers prior to the commencement of services, to undertake a home risk assessment to ensure that Workplace Health and Safety requirements are met, and the Client's home is a safe workplace for staff and other visitors.
Inform Reframe Careers if there is particular requirements regarding access to the home (e.g., key lock box, rear entrance).
Take reasonable steps to provide a safe environment, including not smoking, securing pets away, and being free from the influence of non-prescription drugs and excessive alcohol while service is being provided to the Client.
Take reasonable steps to confirm the Client's safety if they are not answering the door or phone for a scheduled visit; this may include trying other entrances to the property (if the supports are being provided in the home), phoning the representative/substitute decision maker/s or notifying the Police.

Are there any safety concerns? *

YesNo

Please provider further info *

Documentation Aides

Use of AI Technology in Supports

At Reframe Careers, your wellbeing and the quality of your care are our highest priorities. To support our work together, your Career Counsellor may occasionally use AI-powered software during video conferencing and telehealth sessions. This technology helps us capture key details from our discussions - such as treatment goals, vocational plans, progress updates, and outcomes - in real time.

The purpose of this AI software is to reduce the need for manual note-taking, allowing us to concentrate fully on you and your vocational journey. It enhances the accuracy and efficiency of our documentation, ensuring high-quality, client-centred care.

Your informed consent is cruical for us to use these technologies. Be assured that any personal information collected is handled with strict confidentiality and in full compliance with the Privacy Amendment (Enhancing Privacy Protection) Act 2012 and the Privacy Act 1988. Please note that in exceptional circumstances, recorded information (audio and/or visual) may be disclosed without consent if legally required.

Key Points:

AI software assists your Vocational Career Counsellor in taking notes during online sessions.
It helps document your treatment and vocational plans, progress, and outcomes more accurately.
This allows more attention to be focused on your care, rather than administrative tasks.
We will always seek your permission before using this software.
All personal information is stored and managed securely under strict privacy laws.
Recorded material may be disclosed without consent only if legally required.
The sole purpose of using this software is to improve the quality and efficiency of your supports.

Everbility transcribes voice to text, to ensure focus on our discussion rather than note-taking. More information is available here - Everbility: click me

Please check this box to give consent for the use of AI technology with your supports.

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

NDIS Self Managed - negotiate fees for "Employment Services" ONLY (PA +/- Sarah) *Jane this dropdown is for ESS only and if utilising PA or Sarah skills

Hours & details required for Estimate/SA *

Please send this NDIS Client my Calendly booking link

This Private Client will be sent the Calendly booking link automatically, just in case they haven't booked their initial call already.

Any further information for Admin

Delivery method *

Specify time hour duration and km expected for travel (+12h for initial assessment) *

Allocated Counsellor *

Counsellor Email *

Counsellor bio link *If your ESS/CC/RC choice is not available in this list, just use the "about-us" link

Please note that this Full Referral Form DOES NOT GO to the Counsellor to say Yes or No, that already happened through the Enquiry Form.

This form advises them that a Client is being onboarded for them, but is NOT YET ready to be contacted for sessions.

The Private Clients still need to sign their T&Cs, the NDIS Clients need to return their SSA.

Any further information for CounsellorThis is sent on the automated workflow email

Once received, please upload further info, if required

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

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

Admin Actions

PLEASE UPDATE CM & ASANA WITH THE FURTHER INFO RECEIVED
Client setup in Case Manager: SEARCH For Client, if not there: + New Case > Next

1st Page - Contact: Name & Address

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

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 Documents)

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

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 notes (NDIS plan dates if NDIS & reason for referral)

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

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

Client setup in Asana

Set up Client in Asana

Add all relevant tags to Client profile in Asana

Create Asana follow up subtasks to contact Referrer each 2 weeks until further documentation received

The Estimate/SA is to be for 12 hours PLUS travel as specified

The Estimate/SA is to be for 12 hours - online services only

New Estimate tab - New Estimate from template
Add in Estimate hours as per instruction - ensure line item matches what requested in Funding section if NDIS
ADD IN KM BILLABLE LINE ITEM - and give 200km
Add in Start and Finish dates as per NDIS Plan
"Synch" dates

IF NDIS SELF MANAGED - Reviewed carefully what fees Jane wants to charge (make changes to Estimate if required) - IF USING EMPLOYMENT SERVICES: *

SELF fees reminder

Self Managed NDIS Client - Employment Support Services - STANDARD FEES
Category - Capacity Building	Support Item Number	Support Item Name	Price per hour
Finding & Keeping A Job	10_016_0102_5_3	Employment Assistance - SERVICE	$80.06
Finding & Keeping A Job	10_016_0102_5_3	Employment Assistance - TRAVEL	$40.03
Finding & Keeping A Job	10_799_0102_5_3	Provider travel - non-labour costs	$1.00 per km
Improved Daily Living	15_053_0128_1_3	Therapy Assistant - Level 2 - SERVICE	$86.79
Improved Daily Living	15_053_0128_1_3	Therapy Assistant - Level 2 - TRAVEL	$43.40
Improved Daily Living	15_799_0128_1_3	Provider travel - non-labour costs	$1.00 per km

Self Managed NDIS Client - Employment Support Services - Negotiated Fees
Category - Capacity Building	Support Item Number	Support Item Name	Price per hour	Price for services with PA Hartnett
Finding & Keeping A Job	10_016_0102_5_3	Employment Assistance - SERVICE	$120.09	$160.12
Finding & Keeping A Job	10_016_0102_5_3	Employment Assistance - TRAVEL	$80.06	$80.06
Finding & Keeping A Job	10_799_0102_5_3	Provider travel - non-labour costs	$1.00 per km	$1.00 per km
Improved Daily Living	15_053_0128_1_3	Therapy Assistant - Level 2 - SERVICE	$130.18	$173.58
Improved Daily Living	15_053_0128_1_3	Therapy Assistant - Level 2 - TRAVEL	$86.79	$86.79
Improved Daily Living	15_799_0128_1_3	Provider travel - non-labour costs	$1.00 per km	$1.00 per km

NDIS Service Agreement

Private Terms & Conditions

Set up (start date is DATE OF REFERRAL) and send SA

Set up and send T&C

The link for the SA will come through the workflow email from SA SF "ACTION NOTE: Service Agreement for"

The link for the T&C will come through the workflow email from T&C SF "ACTION NOTE: Terms & Conditions for"

SMS sent thru CM to Client - "Send SA/T&C via text"

Update Asana info and add "SA sent for signing dd.mm.yy - (link to SA)", change tags, and create a follow up subtask for review every 7 days until returned.

Add the (link to SA) as "Unsigned SA" in Case Manager Alerts Box

Update Asana info and add "T&C sent for signing dd.mm.yy - (link to T&C)", change tags, and create a follow up subtask for review every 7 days until returned.

Add the (link to T&C) as "Unsigned T&C" in Case Manager Alerts Box

THIS CLIENT IS WAITLISTED - ensure this is reflected in CM & Asana

Create Asana follow up subtasks each 3 weeks until further info is received from Jane to progress this Waitlisted Enquiry to Referral

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

Admin completing this Form *

Save and Complete Later