Service enquiry / Referral request

Please complete the information below to request personalised contact from Dementia Australia for yourself, or someone impacted by dementia, to discuss services and supports and how Dementia Australia may be able to assist.

You are welcome to use this form to make an online referral or, if you prefer or if the matter is urgent, you can do so by calling the National Dementia Helpline on 1800 100 500.