make a referral

Referral Form

We have two online referral forms for your convenience. You can refer as either a Care or Healthcare Provider or as a Family Member or yourself. Please begin your referral by selecting the form that applies to you. If you are a Care Provider or Healthcare Provider, you will be redirected to Halaxy - our secure clinical practice management platform - to complete the required details.

As soon as we have assessed this information, our Practice Manager, will be in touch to progress the referral.

Need help? Call the office on 0420 107 002 or email referrals@equippedtofunction.com.au