To register for our Sense Rugby programs or to make a referral for our OT or Exercise Physiology services please email hello@ruralhealthteam.au or fill out the forms below.

We are not currently accepting Speech Pathology referrals due to upcoming leave.

 

The quickest referral method is to select the Blue ‘Refer Yourself/Your Child HERE’ Button below. This will take you to our Client Portal and allow you to register as a new client. Following this you are automatically sent the Service Agreement Form to be placed on our waitlist.

 

If needed, or if you are not the client, please feel welcome to use the Orange Online Referral Form below or emailing us. Please note, this method may take longer to process.

Service Provider - Online Referral Form

REFERRER DETAILS

CLIENT'S DETAILS

I am referring for:

Tick the box if "yes"

To ensure everyone’s safety please answer the following questions:

Tick the box if "yes"

CONTACT/PARENT/GUARDIAN/FURTHER INFORMATION

Please note, referrals will not be accepted without consent.

This helps us prevent spam, thank you.

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