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Register as a First Time Client

Home 5 Register as a First Time Client Form

Thank you for selecting Stryder. We appreciate that you would like to use our services. We have designed the registration process and form to be friendly and straightforward, so that we can warmly welcome you into our Stryder client community.

Please note: If you are an NDIS recipient, please first complete our NDIS quote request form HERE and we will be in contact.

"*" indicates required fields

1PART A

2PART B

3PART C

4PART D

5PART E

CLIENT DETAILS

Title*

Given Name*

Family Name*

Date of Birth*

DD slash MM slash YYYY

Age

Gender*

Usual Address*

Suburb*

Postcode*

Phone*

Mobile

Current Address (if different)

Postcode

ADDITIONAL INFORMATION

Emergency Contact Name*

Phone*

Relationship*

Doctor’s (GP) Name

Doctor’s Telephone

Medicare Number*

Country of Birth*

Ethnicity*

Preferred Language*

Do you need an interpreter?*

Yes

Are you Aboriginal or Torres Strait Islander?*

Yes

Are you on a pension?*

Yes

Pension Type*

Full pension

Part pension

Disability

DVA

Card Option

Gold Card

Orange Card

White Card

CARER DETAILS (if applicable)

Will a carer travel with you to provide any necessary help?*

Yes

Carer’s Given Name*

Carer’s Family Name

Date of Birth

DD slash MM slash YYYY

Age

Gender*

Carer’s Address*

Postcode*

State*

Phone*

Mobile

Client/Carer Relationship*

Family

Friend

Other

RISK ASSESSMENT - HEALTH/DISABILITY

Do you have a disability or any health issues that may be relevant to you receiving transport services?*

Yes

Disabilities

Poor balance

Memory Loss

Incontinence

Bariatric

Visual Impairment

Intellectual

Hearing

Physical/Diverse

Psychiatric

Sensory

Speech

other - please describe

Do you travel with:

Guide Dog

Oxygen Cylinder

other

MOBILITY

Can you move independently from your home to the vehicle?*

Yes

Can you manage alone at your destination?*

Yes

How much do you weigh?*

Under 100kg

100-130kg

130-150kg

Over 150kg

Do you require an extension seat belt?*

Yes

Do you need to use a mobility aid or other equipment when you travel?*

Yes

Walking Stick or Frame

Walking Stick?

Walking Frame?

If walking frame, is it collapsible?

Yes

Wheelchair?

Wheelchair Type

Manual

Electric

Model

Weight

< 200kgs

> 200kgs

Collapsible?

Yes

Can you transfer independently from your wheelchair to vehicle seat?

Yes

YOUR ACCESS TO STRYDER VEHICLES:

Our buses have low steps, handrails and wheelchair hoists.
(Hoist can be used by people who have difficulty negotiating the steps as well as those in wheelchairs.)

Can you manage 2 to 3 steps independently?*

Yes

Can you manoeuvre independently in and out of a vehicle?*

Yes

Do you require the hoist to access the bus?*

Yes

Are you able to access the rear seat of a car, if required?*

Yes

Are you confident to travel by a Taxi Service, if necessary?*

Yes

Are there any access issues for the vehicle to your home? E.g. No Stopping, no driveway, narrow driveway, main road, apartment block, retirement village?*

Yes

Please state ALL access difficulties or appropriate meeting point:

How did you find out about us?*

Website

Friend/Family

Health Professional

Brochure

Facebook

Other

My goals for using Stryder are:

I’m interested in using the following services:

Medical or everyday appointments

Social Day Trips

Shopping Services

Lower North Shore Service

Community Access

NDIS Transport

I am an

I am an NDIS Participant

On a Home Care Package (HCP)

Neither

NDIS Number

HCP Provider

I am registered with My Aged Care and have been referred to Stryder (Community Transport, Ryde Hunters Hill) for CHSP subsidised transport.

My AC Number is

I understand that by using this service I consent to Stryder accepting your “My Aged Care” referral, and reporting information to funding bodies for planning and statistical purposes. Stryder is a Commonwealth Home Support Program (CHSP) transport provider.

I understand that from time to time photos or videos may be taken during the course of Stryder’s activities and used for promotional purposes. I agree for my image to be used.*

I agree

I don't agree

Name*

Date*

DD slash MM slash YYYY

CAPTCHA

Keep in touch

Valued Partners & Accreditations

“I would like to thank Robyn, your Customer Service Coordinator for going the extra mile and assisting me with my registration for your service. The whole process went seamlessly, and your drivers were excellent.”

Joseph

“Stryder has a long history in Hunters Hill and is a valued part of our community. When times are tough, organisations such as Stryder are there to assist the most vulnerable. Their recent free information technology classes have also helped older members of our community thrive in a digital world. We are proud to support Stryder and thank them for working with us to get our people to the places they need to go.”

Jacqui, Hunters Hill Council

“Many thanks to all the drivers and bus assistants. They are so helpful and make our social outings wonderful and enjoyable. They are good drivers and we feel relaxed, safe and comfortable.”

Betty – a regular social outing client

“Stav and Malia, what a great trip I had, thanks to the both of you. You certainly went beyond your duties always there for us all and taking us to beautiful places, so relaxing. You both worked so hard and never complained. I shall always remember Port Stephen trip so thank you both.”

Joan – a satisfied client who enjoys the long day social outings

“Link Housing is committed to enhancing lives through community housing. Our partnership with Stryder allows us to offer affordable, appropriate and reliable transport services to our residents in Ryde and surrounds. Through transport, Stryder helps our residents to live their daily lives with independence – and stay connected with us and their community. We are proud to partner with Stryder.”

Brianna, Link Housing – Head of Marketing & Communications

“Thanks to all the Community Transport team for your tremendous, support and help. Heartfelt thanks for meeting the needs of people like me.”

Daniel – a satisfied NDIS Client

“Stryder provide invaluable transport services to our residents at Hunters Hill Lodge. Their staff are always friendly, professional, and extremely helpful. Our residents are all able to enjoy our social outings and independent trips due to the brilliant services that Stryder deliver.”

Geoff, Hunters Hill Lodge

“The transport service provided has changed my sister Rosalyn’s life and given her a reason to look forward to work and social outings. Life is brilliant!”

Jeanette – a grateful family member of client

“On behalf of Link Housing’s Community Programs Team, I would like to say THANK YOU to Stryder, particularly Kevin and David who were so helpful during the International Women Day event. Everyone had a great outing and raved about how professional, kind, patient and friendly were your drivers.”

Tash, Link Housing – Community Programs Officer

“I would like to thank you for the many, many years of outings. Stryder has taken me to places that I have never seen before.”

Edith – a happy client

“We have worked in partnership with Stryder for many years and have always found their staff and volunteers a pleasure to work with.”
Zoe, Presbyterian Aged Care

“I would like to compliment Stryder for the lovely drivers for the two trips that were organised for my mother Joy. I live in Brisbane but had the opportunity to accompany my mother on her trips. It has given me the peace of mind knowing that you are looking after my mother.”

Lee – who experienced peace of mind knowing Stryder is there for her mother

“Thank you for my transport to my specialist doctor, I would not have managed without assistance from Stryder. I am very lucky to have this support as it helps to keep me going.”

Daphne – a client who is confident that Stryder is always there for her

“In Hunters Hill, we are very happy with the vehicles, drivers and customer services provided to St Anne’s Aged Care and St. Joseph’s Aged Care over the years.”

Customer Service Manager, Catholic Healthcare

“We have used the services of Stryder transport for a few years and are pleased to say they are the most professional team to work with. Special thanks to Stav and her drivers for always providing a wonderful experience to our organisation and residents with exceptional care and dedication, always going above and beyond to provide phenomenal service.”

Vanessa, Vasey Communities

“Our client Stryder works to support local residents with secure community transport options. Hopscotch has provided outsourced accounting services to Stryder for nearly two years and it is a pleasure to work with an organisation that values its staff and volunteers while providing the local community with an essential service.”

Matthew Knight, Hopscotch Accounting

“Thank you for another breezy partnership (social trip) where everything went smoothly. The ladies commended your driver, Peter, for his patience, politeness and great sense of music!”

Natasha, Link Wentworth

“I especially want to express my thanks to Michael and Denise for their care and attention on our social outing to Pennant Hills. I could not help but notice the extra care both took with one or two clients who required extra support.”

Janet, Stryder