Referral Form

Partners in Recovery Referral Form

Partners in Recovery South West Sydney have reached their maximum client level.

We are committed to support as many consumers as possible before 30th June 2019 and will be placing new referrals on a wait list.  If  a position becomes available we will endeavour to contact the consumer as soon as possible.

You can download a PDF version of this referral form by clicking here.

  • Eligibility Criteria

    Consumers must meet all 7 eligibility requirements to be eligible for PIR.
  • Details of person being referred to Partners in Recovery

  • Referrer's Details

  • National Disability Insurance Scheme

  • Mental health Information

  • Current Supports

  • Please select the boxes that best apply to the consumer:
  • Financial Situation

  • Please select the boxes that best apply to the consumer
  • Functional Capacity

  • Supports Needed

  • Other Conditions

  • Once your referral has been accepted by PIR it will be forwarded to the PIR Team closest to your location. At this time a Support Facilitation Officer will contact you for further discussion

    If you have any further questions please contact our Intake Office on the below number.

For More information

Contact: Danielle Quig Intake Officer at PIR SWS Phone: 1300 747 797 Email: Website: