Expression of Interest

You do not need to explain yourself perfectly.

Short answers, dot points and “I’m not sure” are welcome. Complete the required fields marked * and leave anything optional blank. Choose how you would like us to contact you.

Sending an enquiry does not commit you to a service or reserve a session place.

Who is this for?
Tell us a little about the person looking for support.
Please enter a first name
Please select an age range
If the participant is under 18, a parent, guardian, or authorised representative must complete this form on their behalf.
Please select one
Please enter your name
Please enter the relationship

Only required if you choose SMS or phone contact.

Please enter a mobile number for SMS or phone contact.

We use email to send your intake link. You can choose a different way for us to contact you below.

Please enter a valid email
Preferred way to communicate

Written communication is welcome.

Once enrolled, participants can use agreed asynchronous communication pathways through the Digital Activity Hub for messages, preferences, session briefs, goals and support updates - accessible communication in writing, in your own time, without needing to speak in real time.

What would you like support to help with?
Choose the main support you are enquiring about. If you are interested in more than one, tell us in the notes below. *
Please select what you would like support to help with

Tell us the first date you would like support or sessions to start. We will confirm what is possible.

Please choose a requested start date

Book a chat with us. No pressure. We can help you figure out the right fit.

Fill in what you can below and send your enquiry. Then choose a chat time, so we already know a little about what you need. You can also choose written communication if that works better for you.

We would love to chat about how we can support you. Send this form and you can choose a time for your chat straight after.

One more thing about behaviour support:
If anyone is in danger now, call 000.

Every family is asked these. There are no wrong answers.

We will not contact them without your permission.

Funding
This helps us understand which documents to send you.
You do not have to answer this section if you would prefer not to. We can chat about it when we get in touch.

This helps us prepare a quote for your chosen session. If you are not sure, we will work it out with you.

Before we schedule
So we can prepare properly and keep everyone safe.
If this is urgent or someone is in immediate danger, please call 000. This form is not monitored in real time.
We ask these questions only so we can prepare for safe scheduling and first contact. You can leave these questions blank at enquiry. Before a service begins, we may need some safety, health or support information so we can determine whether we can provide the service safely and appropriately.
Thank you for letting us know. This helps us make sure everything is in place before your first session. We will follow up with you directly.
Before you submit
We only collect what we need to respond safely. You can tell us more later.
Please confirm the required statements before submitting
Your privacy: Neurodivergent Empowered collects the information on this form to respond to your enquiry, assess whether and how we can support the participant, keep them safe, and arrange intake and scheduling. It goes to our team and into our secure records system. With your agreement, or where the law allows, we may share relevant details with people involved in the participant's support, such as a plan manager or support coordinator. Some of our systems store information overseas, as our Privacy Policy explains. You do not have to give every detail, but if information we need is missing we may not be able to respond or offer a safe service. Our Privacy Policy explains how we handle information, usual disclosures, and how to request access or correction or raise a privacy concern.

Our team aims to respond within two business days.

✓

Thank you

We have received your Expression of Interest and we are glad you reached out.

Our team aims to respond within two business days.

After you send your enquiry

  1. We get in touch

    Our team aims to respond within two business days, using your preferred contact method. You can continue in writing if that works better for you.

  2. We explore what could help

    Together, we discuss what matters to you, the support you are looking for and any communication, sensory or access needs. You do not need to arrive with formal goals.

  3. You decide whether to go ahead

    If suitable support is available, we explain the options, fees and arrangements. You choose whether to proceed, and we agree the details with you before support begins.

How we plan support with you

A practitioner reviews your support needs and whether further assessment is needed. Together, we plan what helps, what to avoid and how you want your team to work with you.

Your service agreement sets out the support, delivery arrangements and fees. Once support begins, we record what is provided and review with you what is helping and what needs to change.

Neuro-Affirming Counselling and Specialist Behaviour Support are individually assessed and agreed separately from interest-based supports.

Plan managers and support partners can contact us for more information about how support is assessed, delivered and documented.