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REFERRAL FORM 18+ ONLY

We provide 15-minute free confidential phone consultation for all NEW referrals

Call Crystal Halloran on 0434 017 481


1. Please fill in the enquiry form for an email or call back. 

Please do not leave  ANY private and personal information in the form; Please only provide return email or contact details in the message box. 

Or 

Anyone 18+ fill in the referral form & email it back. 


2.  All enquiries will be responded to within 24hrs of receiving.  


*FOR ALL CHILDREN & YOUNG PEOPLE REFERRAL AGED 7-17YRS - PLEASE CONTACT US DIRECTLY.

If you require help call 000


For Crisis Support 24/7 


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Suicide 

Call Back Service 

1300 659 467


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24/7 

Lifeline Crisis Counselling 

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1800respect 

Sexual abuse and Domestic Violence 

1800 737 732

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