Contact us CALL 1300 111 881 EMAIL customerservice@senses.org.au Your detailsEnquirer's Name * Required Name Surname Phone * RequiredEmail * Required I would like this service for * RequiredMeFamily member who is under 18 years oldFamily member who is over 18 years oldA friendPreferred method of contact * RequiredPlease SelectEmailPhoneMailOther - please stateName and age of the person who the services are for * Required Name Age Main diagnosis of the person who the services are for: Surburb in which this person lives: * Required Street Address ServicesThe services I would like are: Therapy Services Specialist Deafblind Services Assistance for me at home Assistance for me in the community Positive Behaviour Support Therapy workshops and support groups Respite Services Orientation and Mobility Supported Independent Living How the services are to be funded? NDIS Plan Fee for service Other How did you find out about SensesWA?Referral e.g. friend, family member, support coordinatorGoogleSocial mediaEvent or expoOtherOther CommentsAdditional InformationAdditional information - (e.g Copy of NDIS Plan)Max. file size: 256 MB.CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
