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Online Referral Form

Living Without Worry Counselling
and Allied Health

Together, we can do more than we can do alone. Let’s bring our abilities and passions together to affect real change.

There are many ways to join us and support our mission. Contact us to find out more about counselling and NDIS support coordination, fundraising events, and ways that you can get our message to your friends and family.

If you need assistance completing the form phone us on 1300 889 609

LWWHC Referral and Intake Form

This referral and intake form is to provide LWWHC with the necessary details to provide the best matching service and clinician.

Telehealth is available Nationwide outside of the Southeast Queensland area.
If you require urgent assistance (within 48 hours) please contact us on 1300 889 609.
If you need more than one service enter them into the information section at of this enquiry form.
Please enter First Name and Surname.
A language translater can be arranged.
Select any medical conditions the client has currently or has had in the past:

Initial Risk Assessment

Is a home visit expected to be conducted by LWWHC clinician?(Required)
Is a community visit expected to be conducted with the client by LWWHC clinician?
If a community visit is expected with the client by LWWHC clinician, which type?
Will the client require a home visit at night or outside of normal working hours (Mon-Fri 8am-4pm)?
Does the client have any pets?
If the client has pets, will they be securely locked away during the visit?
Are additional persons expected to be present at the time of the visit?
Family, Other service provider, Other resident of the property, Not Sure
Are the client / carers aware of the proposed visit?(Required)
Have the client / carers consented to the proposed visit?(Required)
Is the premises easily accessible from the street?
Is the house visible from the street?
Is the property remote?
Max. file size: 64 MB.
eg. GP Referral, MH Care Plan, NDIS Plan, Other
Your enquiry/referral is important to us at LWWHC. Once you submit this form a response will be emailed to you. We will call you if you request a call back. We may need some time to check service(s) availability. We aim to respond within 48 hours of receiving your enquiry/referral. We may phone you if the information needs further verbal clarification. Service(s) availability is 1-2 weeks at this time, once we receive the LWWHC Referral and Intake Form or Consent and any necessary supporting documents for example a GP Referral, MH Care Plan, NDIS Plan. Some forms or documents can be arranged during the initial appointment. If you need a LWWHC service immediately (within 48 hours) please phone us 1300 889 609 to check availability. Alternatively, you can use the Book Now option on this website and we will contact you if any further information is needed to confirm the appointment.
I consent for Living Without Worry Health Clinic (LWWHC) to collect, store and utilise this personal information for the purposes of providing services for/to me in accordance with the relevant privacy legislation and any other legal requirements that may apply.

Stories of Growth

Discover the impact of our specialised services first hand as individuals share their transformative experiences in the testimonials section, offering insights into the positive outcomes achieved at Living Without Worry Health Clinic.

  • Living without Worry Clinic provides reliable and highly professional services. With their support, I am back to my social life and on the right track to my mental recovery journey. They support me to increase my NDIS funding, which allows me to have the most appropriate support in my life now.

    – Tommy W.

  • I am extremely happy with the service I have received from Living without Worry Clinic. They understand my situation and support needs with a gentle and warm-hearted approach. Under their professional support, I have dramatically increased my NDIS funding, which better meets my daily mental and physical support needs.

    – Jenny W.

  • I have received friendly, trustworthy and quality services from Living without Worry Clinic. They have improved my mental wellbeing and my life quality as a whole. I highly recommend this service.

    – Jacqueline E.