Become a Customer

Are you an individual seeking support from Aratok Disability Support Services?

Fill in your details below and the team at Aratok will be in contact with you to support you through your life journey.

Date

Where did you hear about us?

Name

First Name *

Last Name *

Residential Address

Street

Suburb

State

Postcode

D.O.B

NDIS No.

Identifies as

Aboriginal Torrest Strait Islander CALD N/A

Primary Contact *

Phone *

Mobile

Alternate Contact

Phone

Mobile

Email *

Do you have Support Coordination in your NDIS plan?

Yes No

Further Information