Request a service

Our team can answer your questions about any of our services.

Referrals are welcomed from individuals, family members and health professionals. All responses are mandatory unless otherwise specified.

Fields marked with * are required.

I’m making the referral for: *

Title

First name *

Last name *

Position

Company

Phone number *

Email *

Your relationship to the person you’re referring *

Title

First name *

Last name *

Phone number *

Email *

What support do you require from Guide Dogs Queensland? *

By proceeding, I agree to have my personal information handled in accordance with Guide Dog Queensland's Privacy Policy.

Ready to continue?

Seems like you have filled this form earlier. Let’s pick up where you left off.

We need your help

to give the 20 Queenslanders on our waitlist a miracle of their own this Christmas - a loving, loyal Guide Dog

Donate Now Donate Now