Physiotherapy Referral Forms for Health and Support Professionals
Referring someone to YouGo Physio is simple, fast, and flexible. Whether you’re a GP, support coordinator, case manager, or allied health professional, we make the referral process straightforward so your clients can access mobile physiotherapy at home without delay – no waiting room, no transport barriers.
As a registered NDIS provider, we accept referrals for NDIS participants, Support at Home clients, and privately funded patients across Edithvale and Melbourne’s south-east Bayside region. Our services include falls prevention, pain management, post-operative rehabilitation, mobility support, assistive technology assessments, and NDIS progress reports.

NDIS Referral Form
Complete this form to refer an NDIS participant for mobile physiotherapy at home. We support agency-managed, plan-managed, and self-managed participants under Capacity Building – Improved Daily Living or Core Supports depending on your client's plan.

Support at Home Referral Form
Submit this form to refer a client receiving Support at Home (formerly My Aged Care Home Care Package) funding. Our mobile physiotherapist will contact the client or their nominated representative within one business day.

Private Intake Form
For privately funded patients, complete this intake form to book a mobile physiotherapy visit at home. Suitable for GP referrals, chronic disease management plans, and self-referred patients across Melbourne's south-east.
Get Started With a Mobile Physiotherapist in Edithvale
Not sure which form to use, or want to discuss a referral before submitting? Call us on 0473 393 383 or submit an enquiry – we’re available Monday to Friday, 9 am to 5 pm.


