Get General Referral Form Pdf Version - Headspace

Filling out the General Referral Form for Headspace is an essential step in accessing mental health services for young people. This guide provides a clear, step-by-step approach to ensure that users can accurately complete the form without confusion.

Follow the steps to fill out the form accurately.

1. Press the ‘Get Form’ button to access the General Referral Form, which will open in a digital editor for immediate use.
2. Begin by entering the date in today's date field to provide a clear reference for the submission.
3. Complete the young person's name and preferred name fields. Entering a preferred name can help personalize the communication.
4. Indicate the young person's gender by selecting the appropriate option. If they identify as 'Other,' write the identification in the space provided.
5. Fill in the date of birth to verify the young person's age and eligibility for services.
6. Provide the young person's address, suburb, and postcode to establish their residence.
7. Fill out the contact information, including home phone, mobile phone, and email, for appropriate communication.
8. Confirm whether the young person agrees to the referral by selecting 'Yes' or 'No.' Please note that consent is mandatory.
9. Indicate if the young person has a Mental Health Treatment Plan by selecting 'Yes' or 'No.'
10. If the young person is under 16 years, indicate whether the parents or carers are aware of the referral.
11. Provide parent or carer contact information, including their phone number and email, for follow-up.
12. Select the preferred contact method for communication with the young person.
13. State whether SMS can be used to confirm appointments and provide the young person's Medicare number and reference number, along with its expiry date.
14. Fill out referrer details, including name, service, address, postcode, phone, fax, and email.
15. Indicate if ongoing support from the service provider is planned by selecting 'Yes' or 'No' and providing the name and phone number if applicable.
16. List any other services the young person currently receives support from, along with contact details.
17. Detail the primary reason for referral by selecting the appropriate option: Mental Health, Drug and Alcohol, or Vocational.
18. Fill in any pertinent information about the young person under the designated headings, such as Home and Environment, Education and Employment, and other areas.
19. Complete the signatures section for both the referrer and the young person to validate the referral.
20. Once all fields have been completed, save your changes, download the completed form, print it for physical submission, or share it with relevant parties as needed.

Start filling out the General Referral Form online today to help the young person access the support they need.