Forms

You can find all of our service forms here. If you require a form in another format, or if there is form you require that isn't listed below, please contact our friendly team on
(08) 9381 0600.

Request for Indigo Services

body only male in jeans and shirt checking wheelchair security on bruno lift

Indigo General Request Form (pdf)

366 KB

Indigo General Request Form (Word) (docx)

93 KB

Goods, Equipment and Assistive Technology (GEAT) and Home Modifications Forms

GEAT General Request Form (pdf)

431 KB

GEAT Personal Alarm Request Form (pdf)

522 KB

Home Modifications Request Form (pdf)

227 KB

Driving Services Forms

Male in Indigo uniform standing next to male in driver seat of white car door open

Indigo OT Driver Assessment Referral Form 2020 (pdf)

245 KB

Driver Vision Screen Private Vehicle Driver (pdf)

228 KB

Indigo OT Driver Assessment Self Referral Form 2020 (pdf)

236 KB

Driver Vision Screen Commercial Vehicle Driver (pdf)

407 KB

Hire form

female indigo staff handing over a wheelchair to female customer indigo support graphics picture in background

Indigo Hire Booking Request Form (pdf)

611 KB