Contact | RIAC | Rights Information and Advocacy Centre

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

Name (Name of person with Disability)(Required)

Please write the first and last name

Phone Number(Required)

Email Address (Optional)

Address?(Required)

If no address, please enter suburb of current location

Are you currently Homeless?

Date of Birth(Required)

Please enter in format: DD/MM/YY This can be estimated

Name of Referrer (if not self)

Do you give consent, or have the consent of the person to make this referral?(Required)

If you do not have consent, please ensure that you have this before going any further

Email Address Referrer (Optional)

Phone Number (Referrer)

Do you identify as having a Disability or Mental ill-health (also known as psychosocial disability)(Required)

Yes

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)

Intellectual Learning

Psychiatric

Sensory/Speech

Physical/Diverse

Not Stated/Adequately Described

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 us?(Required)

How did you hear about our services?

Are You?(Required)

*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

Do you or the person you are referring have a Carer?(Required)

Gender(Required)

If Gender is self-described, please specify

OPTIONAL

Country of Birth?(Required)

Main Language Spoken at home?(Required)

Do you (or the person you are referring) Identify as Aboriginal and/or Torres Strait Islander?(Required)

Are you part of a 'diverse' group? If so, please choose which group you identify with:

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

NDIS Eligibility(Required)

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

Are you having a conflict that may require mediation?

If so, please name who you are having a dispute with, and describe what it is about.

About your issue

What is happening that you need support with?(Required)

Please give a short summary

Do you (or the person you are referring) have support from any other people or agencies (family, support worker etc.)? If YES, please list

Optional

Are you interested in making a submission to the Disability Royal Commission OR want someone to contact you about this?(Required)

The best way to contact you?(Required)

Emergency Contact Name

Emergency Contact Number/ Email

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

What does your (or the person you are referring) household look like?

Employment Status?

This will not affect your ability to access our services

What is your main source of income?

This will not affect your ability to access our services

Are you paid weekly or fortnightly?

What is your annual income in $AU (estimated)?

This will not affect your ability to access our services

Do you have a VISA?

If so, what is your migration visa category?

Date of arrival in Australia (if relevant)

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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Phone Number

How to contact or refer to RIAC

THE INTAKE OFFICER

PO BOX 1763 SHEPPARTON VIC 3630

Intake Form

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

About your issue

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

Please click SUBMIT Below to send to us.

FEEDBACK PAGE

WE LOVE FEEDBACK

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