Referral After receiving your referral, Khalia Care will contact you to create a personalised Service Agreement tailored to the participant and their nominated representative. Referrer Details Enter First Name Enter Last Name Relationship with Participant Enter Email Enter Phone I would like to refer My Self A Family Member A Participant NDIS Participant Details Enter First Name Enter Last Name NDIS Participant Number NDIS plan start date NDIS plan end date NDIS Managed Self Managed NDIS Managed Plan-managed Please select the services that you are interested in High-Intensity Daily Personal Activities Community nursing care Daily life tasks or shared living Travel/transport arrangements Daily personal activities Daily living and life skills Participation in community Household tasks In-Home Nursing Care Palliative Care at Home In-Home Dementia Care Post Hospital Support Personal Care Cleaning & Domestic Assistance Meal Preparation & Shopping Respite Support for Carers Companionship & Social Support Community Engagement Transport Please attached current NDIS Plan if available More Information Special requests or more information you would like to tell us Submit Now