How to contact or refer to RIAC

We give you plenty of options to make sure your enquiry gets to us.

You can call our Intake officer on (03) 5222 5499

OR you can email us at referrals@riac.org.au

OR you can send a letter to:
RIAC

THE INTAKE OFFICER
PO BOX 1763 SHEPPARTON VIC 3630

Intake Form

Please write the first and last name
If no address, please enter suburb of current location
Please enter in format: DD/MM/YY This can be estimated
If you do not have consent, please ensure that you have this before going any further
Do you identify as having a Disability or Mental ill-health (also known as psychosocial disability)(Required)
You must have a disability or be the carer of a person with disability (Access & Support program and Supporting Parents Groups) to be eligible to access our services. You do NOT require evidence of a diagnosis/condition, self-described is accepted.
Which listed condition best describes your Disability?(Required)
Please choose one or more of the above. If person is the carer, please state the care recipient's diagnosis/condition.
How did you hear about our services?
*If you are a parent of a person with Disability - who is over 18 -you will need legal guardianship or consent to make decisions on their behalf

OPTIONAL
you can choose only one in this category, so please add more to the next question if required

Only complete this next section if you are referring to our mediation service

About your issue

Please give a short summary
Optional

The following questions are optional, but we would love to gather this data for our reporting so that we, and our funding bodies can look at services and supports needed in our region

This will not affect your ability to access our services
This will not affect your ability to access our services
This will not affect your ability to access our services
MM slash DD slash YYYY
Please tick if you would like to subscribe to our eNewsletter and for any information or updates
Please make sure you have provided your email address in the contact details

Please click SUBMIT Below to send to us.

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