Refer A Client | Nourishing Neighbours

Due to increased demand on our services we can no longer extend the period of crisis food relief any further than 3 months.

Are you a case manager who has previously referred clients to Nourishing Neighbours?(Required)

If you haven’t referred to us before, please contact us via email to let us know about your role, what organisation you work for and the clients you assist. Email: Vaissy@nourishingneighbours.org.au

Yes

Case Management(Required)

As per our conditions, we only accept referrals of clients being actively case managed

Unable to proceed
We accept clients who are receiving active case management via referral by a support agency partner.

Has your client committed to attending our service and attend at their booked time at Martin Reserve, 67 Box Forest Road, Hadfield)(Required)

Unable to proceed
Clients must be made aware that they need to book their appointments online and pickup their food items at their booked appointment time. Clients must be made aware that any appointments they are unable to attend need to be cancelled online at their earliest convenience

TO PROCEED YOU MUST INFORM YOUR CLIENT that if they cannot attend an appointment they need to cancel the appointment online ASAP.

NB multiple failures to pickup orders may result in suspension from service

Your Details (the referrer)

Referrer Name(Required)

First Last

Organisation(Required)

Email(Required)

Enter Email Confirm Email

Phone(Required)

Client Details

Name(Required)

First Last

Email(Required)

Please double check client email is correct.

Enter Email Confirm Email

Phone(Required)

Number of ADULTS needing food relief(Required)

Number of CHILDREN needing food relief(Required)

List Ages & Sexes of Children

This helps us provide nappies, formula and appropriate toys for kids

Income Streams(Required)

List all income streams for all members of the household. (i.e. Mum- Centrelink Payments, Dad- Not eligible for Centrelink, Adult Children- Centrelink

Total Household Income per Fortnight ($)(Required)

Include all members of the household per fortnight. A NUMERICAL AMOUNT must be given

Financial Counselling

We recommend that all clients complete financial counselling whilst receiving food relief to be proactive in the management of their financial situation. Please state if you have referred your client for financial counselling and the estimated completion date. If you haven't referred them please state why.

Reason for referral(Required)

Planning & Intervention(Required)

Outline the supports you & your team will provide in the next 3 months to help your client achieve their goals

What barriers are there to more reliable income streams for your client & family(Required)

Does your client have any history of violence or substance use? If so, please outline any relevant information to help keep our volunteers and clients safe.

3 Month Relief Period(Required)

Our food relief is for a maximum of 3 months ONLY. We can no longer offer extensions to this period due to rapidly increasing referrals.

What is the expected timeframe for your client to become less reliant on our services(Required)

Username (Do not delete)