Expression of interest

Are you filling out this form for yourself or for someone else? *
Preferred contact method
Relationship to client
Participant date of birth *
I'm interested in
Funding type
How did you hear about us?
(how did you hear about us)
(maximum 1000 characters)

Privacy statement: In submitting this form I agree to my details being used for the purposes of an expression of interest in DHS Disability services. The information will only be accessed by necessary DHS Disability Services staff. I understand my data will be held securely, will not be distributed to third parties and DHS Disability Services will treat any personal information provided by me as confidential and only for the purposes indicated above. I have a right to change or access my information. I understand that when this information is no longer required for this purpose, official procedure will be followed to dispose of my data.

Page last updated 3 March 2025