A Professional Organising and Decluttering Service in Geelong, Victoria

    Date of Referral:

    Client's Details

    She/HerHe/HimThey/ThemPrefer not to say

    Referrer Details

    Is funding received through any of the following?

    NDISHome Care PackageDVA (Dept of Veteran Affairs)DFFS (Dept of Family, Fairness and Housing)Other

    If NDIS Participant:

    Plan ManagedSelf-Managed

    Areas of concern:

    KitchenBathroom/sToilet/sVacuuming and mopping floorsDustingLaundryOther

    Frequency of cleaning:


    Preferred Day:


    Preferred Time:


    Additional Notes: