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Use this form to record information about a child aged 0 to 6 years with developmental delay or disability who is seeking support through the NDIS.
After talking with your child's health or educational professional our early childhood partners can help you connect to the right supports. You do not need a referral or diagnosis from a medical professional to access support through our early childhood approach.
If you require support to complete this referral you can contact us on 1300 012 293.
When completing this form, we will ask you if families are informed and agree to this referral. This includes discussing the developmental information that you will provide to Meli.
Please note that if it is unclear whether a child meets the developmental criteria for access to the NDIS it is likely that a period of Early Supports will be offered prior to this step.
Educators and professionals can arrange a secondary consultation and/or request a referral form by calling 1300 012 293.
Please use this form to record information about a child aged under seven years with developmental delay or disability who is seeking support through the National Disability Insurance Scheme (NDIS).
Early Childhood Early Intervention (ECEI) is funded by the NDIS. ECEI can offer a range of supports for eligible children under seven years.
The aim of ECEI is to provide parents and families with the knowledge, skills and support to optimise their child’s development and ability to participate in family, early childhood education and care settings, and in broader community life.
A child aged under seven years who has either:
This form may be completed by:
Complete the ECEI referral to Early Childhood Partner form and record parent/ carer/ guardian/ child representative consent.
If consent is provided by the parent/ carer/ guardian/ child representative, please attach copies of any relevant assessments, reports or letters from health professionals that describe the child’s needs in support of this information form where appropriate.
Further information regarding ECEI can be found at the following website: NDIS Website, ECEI Page or email email@example.com or phone 1300 012 293.
This information assists the Early Childhood Partner to learn more about the child. Please provide information where appropriate and as agreed to by the child’s family, carer or guardian.
Please read consent and privacy information on pages 8 through to 12 and seek signed consent where indicated.
Please provide details of the professional who made the diagnosis or is undertaking the child’s assessment.
Details of the professional completing / assisting with this information form (if any).
The Early Childhood Partner may need to contact the professional listed below to better understand your child’s circumstances and to ensure that your child is connected to the supports that best meet their needs.
Please list the services and supports you are already using to help meet your child’s needs (e.g. GP, paediatrician, maternal & child health nurse, medical specialist, therapist etc.) and the services your child currently attends (e.g. childcare, kindergarten, occasional care etc.)
The Early Childhood Partner may need to contact the people that you list to better understand your child’s circumstances and to ensure that your child is connected to the supports that best meet their needs.
Please read this section carefully. If you have any questions, contact ECEI on firstname.lastname@example.org
BCYF & Bethany have merged! Our two like-minded not-for-profit organisations are now Meli. We’re working together to strengthen our community through all stages of life. In the meantime, you can continue to access all BCYF and Bethany services and programs at bcyf.org.au and bethany.org.au.