Linking Abilities

Linking Abilities

Expression of interest Form
A Social and Dating Program for NDIS Participants
You have come to the Expression of interest Form. For more information, please see our Linking Abilities Flyer below.

All information gathered below will be private and confidential and won't be used for marketing purposes.

If you have any issues completing this form, please contact Caring Lotus on (03)7036-1516
Participant Details

All participants must be at least 18 years old to participate in this program
Full Name*

First NameLast Name
NDIS Number*
Participant's NDIS Number
Date of birth*

DayMonthYear
Date
Mobile Number*
Email*
example@example.com
Phone
Other Number
Participant's Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Meeting new people can be hard and forming healthy relationships (or even knowing what that is) can be even harder.

We have had several people telling us that they find it hard to make friends or form romantic relationships. We would like your help in designing the best platform to help break down any barriers and help these connections to happen.
Why do you want to participate in the Dating/Social group?*
How often would you like to attend? (weekly, fortnightly)*
Would you like to focus on any of the following? (Tick as many as you like)*

What a relationship meansSupport in setting boundaries and keeping yourself safe in relationshipsLearning about and managing feelingsSupport in communication skills and expressing myselfSupport in developing self-care practices that are right for youGoing on datesBeing Supported while on a dateGoing out with a new friendGoing out with a new friend with supportSupport with staying connected with helpful services and people
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Linking Abilities

Participant Details