Contact & apply

We’d love to hear from you

A question, an application, or just finding out which program is the right fit, reach out any time. We’re a friendly bunch.

Where we meet

Jika Jika Community Centre
Northcote, VIC 3070

Apply or refer

Apply or refer to CUSP

Refer yourself, a family member or a client. Choose individual sessions or a group program, fill in what you can, and we’ll be in touch to talk through the next steps. There’s no referral letter required, and no obligation.

What is this referral for?

Choose one — the rest of the form updates to suit.

Individual sessionsOne-to-one speech pathology, at your pace

A group programCreative groups at Jika Jika, Northcote

Your details

If you’re referring yourself, this is simply about you.

I am… *

Your name *

Your email *

Your phone (optional)

Participant details

Participant name *

Date of birth (optional)

Address (optional)

Mobile (optional)

Email (optional)

NDIS participant no. (optional)

TAC no. (optional)

Emergency contact (optional)

Reason for referral (optional)

Consent

I consent to CUSP using these details to respond to this referral, and confirm I have the participant’s permission to share their information where applicable. *

Your information is kept private and used only to respond to this referral. See our privacy policy.

Get involved

Volunteer with CUSP

We’re always glad to hear from people who’d like to volunteer with our groups. Tell us a little about yourself and we’ll be in touch.

We’d love to hear from you

Email

Phone

Instagram

Where we meet

Apply or refer to CUSP

Thank you, your referral is in.

Volunteer with CUSP

Thank you, we’ve got it.