Home Place Offer – ... Place Offer Continence & Toileting Support Please complete the form below to start services. "*" indicates required fields Your Name* First name Surname Phone*The best time to contact me is: Email* Will you be the person receiving therapy services?* Yes No Service user name*This is the person who will receive therapy services. First name Surname Funding available:* NDIS Improved Daily Living: 10+ hours NDIS Improved Relationships (Behaviour Support only): 20+ hours for ongoing support NDIS Improved Relationships (Behaviour Support only): 10+ hours for Functional Behaviour Assessment I'm not sure Other Please provide funding details* Upload a copy of your NDIS Plan (if available)Max. file size: 30 MB.