{"id":923,"date":"2026-08-16T06:09:11","date_gmt":"2026-08-16T06:09:11","guid":{"rendered":"https:\/\/aakproperties.ae\/unitedtribe\/?page_id=923"},"modified":"2026-08-16T20:42:22","modified_gmt":"2026-08-16T20:42:22","slug":"online-referral","status":"publish","type":"page","link":"https:\/\/aakproperties.ae\/unitedtribe\/online-referral\/","title":{"rendered":"Online Referral"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"923\" class=\"elementor elementor-923\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-56a6949 e-flex e-con-boxed e-con e-parent\" data-id=\"56a6949\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9e04882 elementor-widget elementor-widget-shortcode\" data-id=\"9e04882\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\n    <div class=\"ut-referral-container\">\n        \n        <!-- HEADER -->\n        <div class=\"ut-referral-header\">\n            <span class=\"ut-badge-blue\">Online Referral<\/span>\n            <h1 class=\"ut-referral-title\">Start Your Journey With <br><span class=\"ut-flame-highlight\">UnitedTribe<\/span><\/h1>\n            <p class=\"ut-referral-intro\">Tell us a little about yourself and the support you\u2019re looking for. Our team will contact you to discuss the next steps.<\/p>\n        <\/div>\n\n        \n        <!-- FORM CARD -->\n        <form action=\"\" method=\"POST\" enctype=\"multipart\/form-data\" class=\"ut-referral-form\">\n            <input type=\"hidden\" id=\"ut_ref_nonce\" name=\"ut_ref_nonce\" value=\"324703a4dd\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/unitedtribe\/wp-json\/wp\/v2\/pages\/923\" \/>\n            <!-- FIELD 1: Who are you referring -->\n            <div class=\"ut-form-step\">\n                <label class=\"ut-step-label\">1. Who are you referring to?<\/label>\n                <div class=\"ut-chip-grid\">\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_ref_for\" value=\"Myself\" required> <span>Myself<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_ref_for\" value=\"Family member \/ loved one\"> <span>Family member \/ loved one<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_ref_for\" value=\"Participant I support\"> <span>Participant I support<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_ref_for\" value=\"Other\"> <span>Other<\/span><\/label>\n                <\/div>\n            <\/div>\n\n            <!-- FIELD 2: Your details -->\n            <div class=\"ut-form-step\">\n                <label class=\"ut-step-label\">2. Your details<\/label>\n                <div class=\"ut-form-row\">\n                    <div class=\"ut-input-group\">\n                        <label for=\"ut_name\">Full Name *<\/label>\n                        <input type=\"text\" name=\"ut_name\" id=\"ut_name\" required placeholder=\"e.g. Jane Doe\">\n                    <\/div>\n                    <div class=\"ut-input-group\">\n                        <label for=\"ut_phone\">Phone Number *<\/label>\n                        <input type=\"tel\" name=\"ut_phone\" id=\"ut_phone\" required placeholder=\"0400 000 000\">\n                    <\/div>\n                <\/div>\n                <div class=\"ut-form-row\">\n                    <div class=\"ut-input-group\">\n                        <label for=\"ut_email\">Email Address *<\/label>\n                        <input type=\"email\" name=\"ut_email\" id=\"ut_email\" required placeholder=\"jane@example.com\">\n                    <\/div>\n                    <div class=\"ut-input-group\">\n                        <label for=\"ut_org\">Organisation \/ Role (if applicable)<\/label>\n                        <input type=\"text\" name=\"ut_org\" id=\"ut_org\" placeholder=\"e.g. Support Coordinator \/ Apex Care\">\n                    <\/div>\n                <\/div>\n            <\/div>\n\n            <!-- FIELD 3: Plan Management -->\n            <div class=\"ut-form-step\">\n                <label class=\"ut-step-label\">3. How is the NDIS plan managed?<\/label>\n                <div class=\"ut-chip-grid\">\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_plan_mgmt\" value=\"Plan-managed\" required> <span>Plan-managed<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_plan_mgmt\" value=\"Self-managed\"> <span>Self-managed<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_plan_mgmt\" value=\"NDIA-managed\"> <span>NDIA-managed<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_plan_mgmt\" value=\"Not sure \/ Other\"> <span>Not sure \/ Other<\/span><\/label>\n                <\/div>\n            <\/div>\n\n            <!-- FIELD 4: Interested Supports -->\n            <div class=\"ut-form-step\">\n                <label class=\"ut-step-label\">4. What support are you interested in? <small>(Select as many as needed)<\/small><\/label>\n                <div class=\"ut-checkbox-grid\">\n                    <label class=\"ut-chip-item\"><input type=\"checkbox\" name=\"ut_supports[]\" value=\"Personal Care & Daily Living\"> <span>Personal Care & Daily Living<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"checkbox\" name=\"ut_supports[]\" value=\"Community Access & Participation\"> <span>Community Access & Participation<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"checkbox\" name=\"ut_supports[]\" value=\"Household Support\"> <span>Household Support<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"checkbox\" name=\"ut_supports[]\" value=\"Transport & Appointments\"> <span>Transport & Appointments<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"checkbox\" name=\"ut_supports[]\" value=\"Life Skills & Independence\"> <span>Life Skills & Independence<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"checkbox\" name=\"ut_supports[]\" value=\"Supported Independent Living (SIL)\"> <span>Supported Independent Living (SIL)<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"checkbox\" name=\"ut_supports[]\" value=\"Community Nursing\"> <span>Community Nursing<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"checkbox\" name=\"ut_supports[]\" value=\"High Intensity Supports\"> <span>High Intensity Supports<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"checkbox\" name=\"ut_supports[]\" value=\"Group & Centre-Based Activities\"> <span>Group & Centre-Based Activities<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"checkbox\" name=\"ut_supports[]\" value=\"Behaviour Support\"> <span>Behaviour Support<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"checkbox\" name=\"ut_supports[]\" value=\"Support Coordination\"> <span>Support Coordination<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"checkbox\" name=\"ut_supports[]\" value=\"Other \/ Not sure\"> <span>Other \/ Not sure<\/span><\/label>\n                <\/div>\n            <\/div>\n\n            <!-- FIELD 5: Timeline -->\n            <div class=\"ut-form-step\">\n                <label class=\"ut-step-label\">5. When would you like support to start?<\/label>\n                <div class=\"ut-chip-grid\">\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_start_time\" value=\"As soon as possible\" required> <span>As soon as possible<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_start_time\" value=\"Within 1\u20132 weeks\"> <span>Within 1\u20132 weeks<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_start_time\" value=\"Within a month\"> <span>Within a month<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_start_time\" value=\"Flexible\"> <span>Flexible<\/span><\/label>\n                <\/div>\n            <\/div>\n\n            <!-- FIELD 6: Text Box -->\n            <div class=\"ut-form-step\">\n                <label class=\"ut-step-label\">6. Tell us briefly how we can help<\/label>\n                <div class=\"ut-input-group\">\n                    <textarea name=\"ut_message\" rows=\"5\" placeholder=\"What support are you looking for, and is there anything important you would like us to know?\"><\/textarea>\n                <\/div>\n            <\/div>\n\n            <!-- FIELD 7: Preferred Contact -->\n            <div class=\"ut-form-step\">\n                <label class=\"ut-step-label\">7. Preferred contact method<\/label>\n                <div class=\"ut-chip-grid\">\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_pref_contact\" value=\"Phone\" required> <span>Phone<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_pref_contact\" value=\"Email\"> <span>Email<\/span><\/label>\n                    <label class=\"ut-chip-item\"><input type=\"radio\" name=\"ut_pref_contact\" value=\"SMS\"> <span>SMS<\/span><\/label>\n                <\/div>\n            <\/div>\n\n            <!-- FIELD 8: Optional Document Upload with Live Preview -->\n            <div class=\"ut-form-step\">\n                <label class=\"ut-step-label\">8. Optional document upload<\/label>\n                <p class=\"ut-sub-note\">You can upload an NDIS plan or referral document if you have one. This is not required to submit your referral.<\/p>\n                \n                <div class=\"ut-file-upload-container\">\n                    <div class=\"ut-file-upload-box\" id=\"utUploadDropzone\">\n                        <input type=\"file\" name=\"ut_document\" id=\"ut_document\" accept=\".pdf,.doc,.docx,.jpg,.jpeg,.png\">\n                        <label for=\"ut_document\">\n                            <i class=\"fas fa-cloud-upload-alt ut-upload-icon\"><\/i>\n                            <span class=\"ut-upload-title\">Choose File or Drag & Drop<\/span>\n                            <small class=\"ut-upload-types\">Supports PDF, DOC, DOCX, JPG, PNG (Max 10MB)<\/small>\n                        <\/label>\n                    <\/div>\n\n                    <!-- PREVIEW BOX (Hidden until file selected) -->\n                    <div class=\"ut-file-preview-card\" id=\"utFilePreview\" style=\"display: none;\">\n                        <div class=\"ut-preview-media\" id=\"utPreviewMedia\">\n                            <!-- Dynamic Icon or Image Preview goes here -->\n                        <\/div>\n                        <div class=\"ut-preview-details\">\n                            <span class=\"ut-file-name\" id=\"utFileName\">document.pdf<\/span>\n                            <span class=\"ut-file-size\" id=\"utFileSize\">1.2 MB<\/span>\n                        <\/div>\n                        <button type=\"button\" class=\"ut-remove-file-btn\" id=\"utRemoveFileBtn\" title=\"Remove file\">\n                            <i class=\"fas fa-times\"><\/i>\n                        <\/button>\n                    <\/div>\n                <\/div>\n            <\/div>\n\n            <!-- CONSENT -->\n            <div class=\"ut-form-step ut-consent-step\">\n                <label class=\"ut-consent-label\">\n                    <input type=\"checkbox\" name=\"ut_consent\" required>\n                    <span>I confirm I have permission to provide this information and consent to UnitedTribe contacting me regarding this referral. *<\/span>\n                <\/label>\n            <\/div>\n\n            <!-- SUBMIT BUTTON -->\n            <div class=\"ut-submit-wrap\">\n                <button type=\"submit\" name=\"ut_ref_submit\" class=\"ut-primary-btn\">\n                    Start My UnitedTribe Journey <i class=\"fas fa-arrow-right\"><\/i>\n                <\/button>\n            <\/div>\n\n        <\/form>\n    <\/div>\n\n    <!-- STYLES -->\n    <style>\n        @import url('https:\/\/fonts.googleapis.com\/css2?family=Montserrat:wght@500;600;700;800&display=swap');\n\n        .ut-referral-container {\n            \n            margin: 60px auto;\n            font-family: 'Montserrat', sans-serif;\n            padding: 0 20px;\n            box-sizing: border-box;\n        }\n\n        .ut-referral-header {\n            text-align: center;\n            max-width: 750px;\n            margin: 0 auto 50px auto;\n        }\n\n        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     line-height: 1.7;\n            color: #57606A;\n            font-weight: 500;\n            margin: 0;\n        }\n\n        \/* FORM BOX *\/\n        .ut-referral-form {\n            background: #FFFFFF;\n            padding: 50px;\n            border-radius: 28px;\n            box-shadow: 0 20px 50px rgba(0,0,0,0.05);\n            border: 1px solid #F4F4F4;\n            display: flex;\n            flex-direction: column;\n            gap: 40px;\n        }\n\n        .ut-form-step {\n            border-bottom: 1px solid #F0F0F0;\n            padding-bottom: 35px;\n        }\n\n        .ut-form-step:last-of-type {\n            border-bottom: none;\n            padding-bottom: 0;\n        }\n\n        .ut-step-label {\n            font-size: 18px;\n            font-weight: 700;\n            color: #2D2D2D;\n            display: block;\n            margin-bottom: 20px;\n        }\n\n        .ut-step-label small {\n            font-size: 14px;\n            font-weight: 500;\n            color: #57606A;\n        }\n\n        .ut-sub-note {\n            font-size: 14px;\n            color: #57606A;\n            margin: -10px 0 20px 0;\n            font-weight: 500;\n        }\n\n        \/* STYLED CHIPS & CHECKBOXES *\/\n        .ut-chip-grid, .ut-checkbox-grid {\n            display: flex;\n            flex-wrap: wrap;\n            gap: 12px;\n        }\n\n        .ut-chip-item {\n            position: relative;\n            cursor: pointer;\n        }\n\n        .ut-chip-item input {\n            position: absolute;\n            opacity: 0;\n            width: 0;\n            height: 0;\n        }\n\n        .ut-chip-item span {\n            display: inline-block;\n            padding: 12px 24px;\n            background: #FAF9F8;\n            border: 2px solid #EAEAEA;\n            border-radius: 12px;\n            font-size: 14px;\n            font-weight: 600;\n            color: #2D2D2D;\n            transition: all 0.3s ease;\n        }\n\n        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4px;\n        }\n\n        .ut-upload-types {\n            font-size: 12px;\n            color: #57606A;\n            font-weight: 500;\n        }\n\n        \/* PREVIEW CARD *\/\n        .ut-file-preview-card {\n            display: flex;\n            align-items: center;\n            gap: 15px;\n            background: #FAF9F8;\n            border: 1px solid #EAEAEA;\n            padding: 15px 20px;\n            border-radius: 16px;\n            margin-top: 15px;\n            animation: utFadeIn 0.3s ease;\n        }\n\n        @keyframes utFadeIn {\n            from { opacity: 0; transform: translateY(-8px); }\n            to { opacity: 1; transform: translateY(0); }\n        }\n\n        .ut-preview-media {\n            width: 50px;\n            height: 50px;\n            border-radius: 10px;\n            background: #EAF4FA;\n            display: flex;\n            align-items: center;\n            justify-content: center;\n            overflow: hidden;\n            flex-shrink: 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center;\n            gap: 10px;\n            background-color: #E5883B;\n            color: #FFFFFF !important;\n            padding: 18px 40px;\n            border-radius: 12px;\n            font-size: 16px;\n            font-weight: 700;\n            border: none;\n            cursor: pointer;\n            width: 100%;\n            font-family: 'Montserrat', sans-serif;\n            transition: all 0.3s ease;\n        }\n\n        .ut-primary-btn:hover {\n            background-color: #D2762A;\n            transform: translateY(-2px);\n            box-shadow: 0 10px 25px rgba(229, 136, 59, 0.3);\n        }\n\n        \/* ALERTS *\/\n        .ut-alert {\n            padding: 18px 24px;\n            border-radius: 12px;\n            margin-bottom: 30px;\n            font-weight: 600;\n            font-size: 15px;\n        }\n        .ut-success { background: #EAF4FA; color: #2E7195; border: 1px solid #4ca3d3; }\n        .ut-error { background: #FDE8E8; color: #C81E1E; border: 1px solid 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