Online Referral Form

Referring to Meals on Wheels

Anyone can refer a client to Meals on Wheels — including family members, friends, hospitals, general practitioners, rehabilitation facilities, community nurses, or dietitians. You can even refer yourself! There are no waiting lists and no contracts.

If you or the person you’re referring are eligible for a funding program such as NDIS, Support at Home Program, or Commonwealth Home Support Programme (CHSP), meals may be included as part of your approved services.

Once a referral is received, your local Meals on Wheels service will contact you to answer any questions, discuss special requirements, and arrange meal delivery. They’ll also go through the menu with you, or provide a copy to review at home.

To start receiving Meals on Wheels, simply complete the online referral form below, or contact your local Meals on Wheels service – [click here to find your local service]. Please note: This form is for Meals on Wheels Brisbane South referrals only and is not a My Aged Care referral form.

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I am: *

• Wanting help for myself
• Family/Friend of someone needing help
• Dr/Health professional

Client Details

Client Name *

First

Last

Do following Name

DOB *

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Client Phone number: *

Email

Address *

Address Line 1

City

State / Province / Region

Postal Code

Please select one of the following *--- Select Choice ---Client has a CHSP Meal referral codeClient has a Support at Home PackageClient has a NDIS planClient is unsure/not registeredClient will be paying full price

Please record your My Aged Care Referral Code (if accessing through CHSP) or your Package Provider details if (Support at Home or NDIS):

Do you have any dietary requirements? (Allergies, intolerances, texture modifications)

Preferred Commencement Date *

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Additional Notes/Comments

If you are filling this out on behalf of someone, please add your details below:

Name

First

Last

Email

Contact Number

Relationship to Client

Submit