Liberty Disability Services will be closed on Monday, March 11th for the Labour Day public holiday. We will re-open as usual at 9am on Tuesday, March 12th.

Group Program Referrals

Once we receive this form we will be in touch to discuss the detail, please don't stress if you can't answer all sections - we will call and go over everything.

Participant Name *
Address
Parent/Carer Details
Please complete the following questions
Please comment on how the below challenges are affecting the participant's community & civic involvement
Funding Information
This referral was made by