Who should use this form

This form is for clinicians, allied health professionals or other practitioners referring a client for an AT trial. If you are referring on behalf of a family, record who holds consent for the client.

Process

We confirm consent and clinical details, complete a short scoping conversation, run a short configured trial in-context, then deliver a concise outcomes report with procurement notes and sustainment options.

Refer your client — form

Replace FORM_ACTION with your form endpoint. Fields marked * are required.

Client details
Referrer (clinician) details
Clinical info & attachments

Accepted: PDF, DOC(X), JPG, PNG. Max total upload per submission: 10 MB (server-side limit required).


Consent & privacy

If the client cannot consent, ensure an authorised substitute decision-maker provides consent and record their details in the clinical summary.

Email founder

We will contact the referrer by email to arrange intake.

Privacy: we use this information only to process this referral. Attachments and clinical notes are stored securely and accessed only by referral staff/clinicians involved in the scoping and trial.

Frequently asked

How long until intake?
We will contact the referrer by email within 5–10 working days to arrange intake. For urgent referrals email founder@edulinked.com.au with subject 'Urgent AT referral'.
How long are trials?
Trials are typically 2–6 weeks depending on goals and devices.