Referral Form

Partners in Recovery Referral Form

Partners in Recovery South West Sydney have offices in Bankstown, Fairfield, Liverpool, Campbelltown / Camden, Wollondilly / Wingecarribee.

Please make sure all information is completed for referrer and consumer.

  • Eligibility Criteria

    Please tick the relevant boxes
  • Referrer's Details

  • Client Details

  • Emergency Contact Person / Next of Kin

  • NDIS

  • Mental Health History

  • Have you been hospitalised with your mental health in the last:

  • Mental Health

  • PIR can assist with a variety of supports, an example of those supports include but are not limited to assistance with finding employment, housing, drug and alcohol issues, social supports, legal issues, and relationships.

  • 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