Eligibility Questionnaire

Please fill in the form below to see if you are eligible to book an appointment.

Your Name

Your Email Address

Your Telephone Number

Please answer the following questions to see if you are eligible for assistance.

Are you between 14-65 years old? YesNo

Are you an Australian Resident? YesNo

Do you have a disability or a mental health issue? YesNo

Permanent Address in region? YesNo

Unfortunately, you will not be eligible for assistance,

However, please call us on our 1800 163 987 to discuss this matter further.

You may be eligible to receive help from us

Please let us know a little more about yourself. Fill in the details below and let us know when you are available for an appointment. All questions are mandatory.

Are you registered with another Job provider? YesNo

Please provide their name:

What payments do you get from Centrelink?
No PaymentsDisability Support PensionNew Start AllowanceYouth AllowanceParenting Payments

Are you working? YesNo

If Yes, How many hours a week? <8>8<15>15<23>23

Are you working Full Time/Full-Time Student? YesNo

If yes, you are not eligible for DES. However, please call us on our 1800 163 987 to discuss this matter further.

Are you working full time? YesNo. *If yes, we can offer you work assist?

*Work assist is provided when a job seeker is working and struggling with employment due to their disability. Nexus can assist job seekers liaise with employer to make any work place adjustment that may suitable to ensure ongoing employment.

Congratulations! You are eligible to receive assistance form us.

Please let us know your location, and what time and day you are available to come in and see us.

Please choose what days you are available to come in and see us.
MondayTuesdayWednesdayThursdayFriday

Please choose a time that you will be available to come in to see us.

Let us know your nearest office. This pull down menu is sorted via State and then Location.

How did you hear about us?