Let’s work together

Thank you for trusting Siobhan at Me and My OT as your Occupational Therapist. After filling in what you can below, I will be in touch with you shortly after.

Client Details

First Name

Last Name

Contact:

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Address:

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Date of Birth:

MM

DD

YYYY

OT service:

Functional Capacity Assessment

Housing Assessment SDA/SIL/ILO

Assistive Technology

Daily Living Skills Therapy

Home Modifications

Mental Health

My Aged Care

Other

NDIS Number:

Plan Manager:

Any other details relevant to referral?

Referrals and funding

Referrals are accepted via email or website from clients, client’s family, GP’s, support coordinators, MAC service provider or any stakeholders involved in the clients’ care.

Please also reach out via phone if you would prefer.

Phone: 0487 168 333

Email: siobhan@meandmyot.com

FUNDING AND FEES

NDIS: Plan managed and self-managed.

My Aged Care: Home Care Package.

Me and My OT set their fees according to the NDIS price guide of $193.99 per hour. This fee is for all services.