1UP ™ Referrals Proccess

We value our partnerships with healthcare professionals and other support services. Below you will find the referral process and the necessary form to refer clients to 1UP Collaborative Gaming™.

Submit the Referral Form:

Please complete the online referral form available on our website. Ensure all required fields are accurately filled to avoid any delays.

2. Contact Information:

After submitting the form, reach out for any initial queries or further assistance via email at referrals@1upcollaborativegaming.com.au or call (07) 2111 8644.

3. Review and Contact:

Our team will review the submitted information and contact the client, guardian, or support coordinator for additional details if needed.

4. Onboarding and Initial Session:

Upon confirmation, the client will be onboarded and scheduled for an initial consultation. We will work closely with the client to tailor our services to their needs.

5. Further Assistance:

If you have any questions or need assistance with the referral process, please contact our team via the provided phone or email.

Referrer's Information

Fill this section if a third party, such as a healthcare provider or support worker, is referring the client.

Referrer's Name

First Name

Last Name

Referrer's Company

Referrer's Relationship to Client

Referrer's Contact Number

Country

(###)

###

####

Referrer's Email Address

Client Information

Please complete this section with the client's details.

Client's Name

First Name

Last Name

Client's Date of Birth

Client's Home Address

Client's Contact Number (if applicable)

Country

(###)

###

####

Client's Email Address (if applicable)

Legal Guardian Information

Include details here if the participant is under 18 or has a legal guardian.

Legal Guardian's Name

First Name

Last Name

Legal Guardian's Contact Number

Country

(###)

###

####

Legal Guardian's Email Address

Reasons for Engaging with 1UP Collaborative Gaming™

Please describe the primary reasons for seeking services from 1UP Collaborative Gaming™, including any specific support needs, challenges, or goals you aim to achieve.

Additional Details

Please provide any relevant additional information.

NDIS Number

Plan Manager's Name

Funding Agency Details

Other (Please specify)

By checking this box, I confirm that the information provided is accurate and complete to the best of my knowledge. I understand and agree to the terms and conditions outlined by 1UP Collaborative Gaming™.

1UP ™ Referrals Proccess

Submit the Referral Form:

2. Contact Information:

3. Review and Contact:

4. Onboarding and Initial Session:

5. Further Assistance:

1UP Collaborative Gaming™