Make a referral
To get started with your referral to VisAbility, please fill in the easy online forms below.
Don’t like filling in forms? No worries! Call us on 1800 847 466 in WA or 1800 484 333 in Tasmania and we’ll take care of everything you need to get you started on your journey to independence today.
Online Referral Form – Children & Youth
To make a referral for children and youth, complete our easy online referral form.
Online Referral Enquiry Form – Adults
To make a referral for adults, please fill in the form below.
VisAbility Referral Forms – Download Now
If you prefer to fill in your referral form and mail or email back to us, please download the relevant form/s below.
- Therapy for Children and Youth Referral Form PDF, 1,775kb
- Adult Vision Services General Referral Form PDF 261kb
- Low Vision Medical Certificate (Adult) – Ophthalmologist / Optometrist Information Form PDF 363kb
- Low Vision Medical Certificate (Child) – Ophthalmologist / Optometrist Information Form pDF 1,116kb
- Acquired Brain Injury Vision Services Referral Form PDF 572kb
If you experience any issues downloading, reading or returning your referral form, please contact us so we can assist you.