HC Renovations · Professional Referrals

OT Home Modification Referral Form

Supporting Occupational Therapists and referrers with home modification enquiries. Use this form to share the relevant participant, property and accessibility information so HC Renovations can review the enquiry and discuss possible next steps.

OT & Professional Referrals Home Accessibility Enquiries NDIS Home Modifications

Modern residential interior with a spacious and practical layout

Make a Referral

Tell us about the home modification requirements

Please provide the information available to you. Details about the participant's needs, the property and the proposed modifications can help us understand the referral. Please avoid including unnecessary sensitive or clinical information in this form.

Referral Details

Submit an OT referral

Fields marked with * are required.

Referrer Information

Referrer Full Name *

Professional Role *

Organisation / Practice

Work Email *

Contact Number

Referral Date

Participant Information

Participant Name *

Participant Contact Number

Participant Email

NDIS Number (if relevant)

Preferred Contact Person

Preferred Contact Method

Property Information

Property Address *

Suburb *

Postcode

Property Type

Property Occupancy

Modification Requirements

Type of Modification Required *

Priority / Timing

OT Assessment / Recommendations

Referral Summary / Requested Work *

Additional Information

I confirm that I am authorised to submit this referral and, where participant information is included, the relevant consent has been obtained for sharing it with HC Renovations for the purpose of this enquiry. *

Submitting this form sends the referral to HC Renovations. Please do not include highly sensitive medical or personal information.

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For OTs & Referring Professionals

This form is intended for home modification enquiries and referrals. Provide the information available to help explain the proposed work and property requirements.

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What to Include

Helpful referral details may include:

Participant and referrer contact information
Property location and type
Modification areas being considered
Brief summary of the access requirements
Assessment status, where relevant

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Referral Email

You can also contact HC Renovations by email for enquiries about the referral process.

Estimate@hcrenovations.com.au

Privacy & Information

Please share only the information needed

This form is intended for initial referral enquiries. Please avoid submitting detailed clinical records, sensitive health information or documents containing unnecessary personal details. Confirm that you have the appropriate consent before sharing participant information. Form submissions are processed through FormSubmit, a third-party form service. Please review the site's privacy information before using this form.