Advocacy Referral & Information Form

PLEASE READ THIS CAREFULLY BEFORE REFERRING A PERSON

Following is an advocacy referral form for Disability Advocacy NSW. This form is designed to be used by organisations and service providers wishing to refer a person with a disability to the service. Individuals with a disability and carers can still seek the assistance of an advocate by contacting us directly. The aim of this referral system is to ensure that we assist clients with the most urgent needs first.

After a referral is received we will prioritise the matter based on the severity of the issue, the severity of the person’s disability, and the person’s access to other supports and will contact the client and the referrer giving an indication of how long it will be before advocacy can begin. Average waiting time is approximately 2-4 weeks.

It will help us a great deal if you can complete the attached referral form and add any additional information that will help us to quickly understand the issues involved. If you have any questions feel free to contact our advocates 1300 365 085 or try our web site www.da.org.au .

Who is the Advocacy Service for?: For people with any type of disability or mental illness.

WHAT DO ADVOCATES DO? Advocates seek to assist people with a disability who have been unfairly treated. (As a guideline, a person with a disability is treated unfairly if he or she is treated contrary to: law, human rights, policy, standards or well accepted conventions (such as procedural fairness/natural justice).

WHAT ADVOCATES CAN’T DO

Provide casework services (e.g. finding accommodation, applying for services, managing services, etc).
Provide advocacy services when a government disability caseworker can provide advocacy support and they do not have a conflict of interest (e.g. help a person with a disability with a pension problem if the disability caseworker works for the state government).
Provide advocacy for a person when a more appropriate service is available (e.g. debt matters where a financial counsellor is available, representation at a tenancy tribunal when a tenants advocacy service is available, provide court support when a suitable court support program is available).
Provide advocacy for a person who wishes to take out an apprehended personal violence order against a neighbour or workmate if appropriate mediation has not been attempted to resolve the dispute.

Areas Covered: Hunter, New England and Mid North Coast regions of NSW Australia.

INDIVIDUAL ADVOCACY

Directly advocating on behalf of a person or providing information and advice so that a person can advocate for themselves.
Linking a person with other relevant services (eg helping a person get help from a solicitor, financial counsellor, tenant advocate, court support worker).
Supporting an individual to take formal action on matters related to disability discrimination or making a complaint against a service provider.

TO CHECK IF YOUR REFERRAL MEETS OUR REFERRAL CRITERIA

Phone1300 365 085 to discuss before completing this form.

Has the person you are referring used the service before	Yes No
Clients surname
Clients first name
Phone
Email
Fax
Address (including post code)
Date of Birth	(dd/mm/yyyy)
What type of disability does the person have?
Cultural background? (eg. Non-English speaking background, Aboriginal, English speaking background)
Contact person/Carer? (If applicable, is there a family member, friend, carer that the service should know about?)
Has the client given permission for DA to contact them	Yes No
Referring person/Agency? (Referring person & agency's name, address, phone, fax and email)
Summarise the main issues by describing how the person with a disability is being treated unfairly
What outcome does the client want? (How would they like an advocate to help?)
How urgent is the matter? (Is there upcoming events that the service needs to know about eg legal proceedings, eviction, appointments, deadlines etc?)

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