Enquire Now

This form is for making enquiries about support services. You can also contact us by phone at (03) 6228 9099 anytime during business hours or by email at Reception@langford.org.au.

• Please do not use to form to apply for a job with Langford or to seek information about employment with Langford. Visit our Careers page for more information.
• Please do not use this form for business marketing purposes. Business enquiries may be sent to communications@langford.org.au

Name *

First

Last

Email *

Phone

You are enquiring about: *

• Community Access
• Supported Independent Living (SIL)
• Respite (Short & Medium Term)
• Specialist Disability Accommodation (SDA)
• Children, Youth & Families
• Community Hub
• Other

Please describe your enquiry: *

How did you hear about Langford? *

• Social media (Facebook, etc.)
• Web search (Google, etc.)
• Printed ad or flyer
• Word of mouth
• Other

Submit