Please be aware that we are currently experiencing a high demand for our counselling service resulting in extended wait-times.

Privacy Statement

Counselling is a private and confidential service. The personal and health information is being collected by Council for the purposes of counselling. This information will be stored in Council’s Customer Database and used to identify the client when communicating with Council and for Council to deliver services and information to the client. We will ensure that the personal information is not disclosed to other individuals, institutions, and authorities outside Council except if required or authorised by law or clear informed consent is given.

The personal information will be handled in accordance with the Privacy and Data Protection Act 2014 (Vic). For further information on how the personal and health information will be handled please refer to Council’s Privacy Policy

In order for us to provide your young person with the most suitable support, please fill all the required sections in this form.
Are you or your young person a resident, studying, working, or recreating in Wyndham? (required)
Please tick if any of the below applies to your young person. (required)

BASED ON WHAT YOU'VE TOLD US, OUR SERVICE MAY NOT BE THE BEST FIT FOR YOUR YOUNG PERSON BECAUSE WE DO NOT SPECIALISE IN SUPPORTING VICTIMS OF SEXUAL ASSAULT. WE SUGGEST SEEKING ASSISTANCE FROM A MORE APPROPRIATE SERVICE. HOWEVER, YOU CAN STILL SUBMIT THIS FORM. IF YOU HAVE ANY QUESTIONS OR WANT TO DISCUSS THIS FURTHER, PLEASE REACH OUT TO OUR COUNSELLING TEAM AT 8734 1355. YOU CAN CONTACT THE SERVICES BELOW TO ACCESS A MORE SPECILASED SERVICE.

Recent Sexual Assault: Please contact West Casa on 1800 806 292 or www.westcasa.org.au or Gatehouse on 9345 6391 or www.rch.org.au/gatehouse/contact/contact_us/ to make a referral into counselling services')

BASED ON WHAT YOU'VE TOLD US, OUR SERVICE MAY NOT BE THE BEST FIT FOR YOUR YOUNG PERSON BECAUSE WE DO NOT SPECIALISE IN SUPPORTING YOUNG PEOPLE WHO HAVE DEVELOPMENTAL ISSUES. WE SUGGEST SEEKING ASSISTANCE FROM A MORE APPROPRIATE SERVICE. HOWEVER, YOU CAN STILL SUBMIT THIS FORM IF YOU BELIEVE YOUR CHILD MAY BENEFIT FROM OUR SERVICE. IF YOU HAVE ANY QUESTIONS OR WANT TO DISCUSS THIS FURTHER, PLEASE REACH OUT TO OUR COUNSELLING TEAM AT 8734 1355. PLEASE REFER TO THE INFORMATION BELOW TO ACCESS A MORE SPECILASED SERVICE.

Please see your GP or refer for NDIS website for further information https://www.ndis.gov.au/

 

BASED ON WHAT YOU'VE TOLD US, OUR SERVICE IS NOT SUITABLE FOR YOUR YOUNG PERSON BECAUSE WE ARE NOT A CRISIS OR EMERGENCY SERVICE.IF YOUR YOUNG PERSON IS IN AN EMERGENCY CALL TRIPLE ZERO NOW (000)OR GO TO YOUR LOCAL HOSPITAL EMERGENCY DEPARTMENT. REMEMBER TO STAY WITH YOUR YOUNG PERSON UNTIL THEY ARE ABLE TO ACCESS PROFESSIONAL SUPPORT. IF YOU OR YOUR YOUNG PERSON IS FEELING OVERWHELMED AND NEED TO SPEAK WITH SOMEONE NOW, CONTACT:

  • Lifeline on 13 11 14
  • Kid help line (for 5–25-year-olds) 1800 55 1800
  • Royal Childrens Hospital 1800 44 55 11 (free call) to make a referral for specialist services.
Young Person's Details
Parent/Carer/Legal Guardian details
Is the parent aware of this referral (required)
Parent/Carer/Legal Guardian Details (2nd person, if applicable)
Emergency contact
Is the emergency contact the same as the Parent/Carer/Legal Guardian? (required)
Is the emergency contact aware of the referral?

Please be advised that we are not a crisis or emergency service, and it may take some time for us to respond to your requests. If you would like to know about the crisis and support services available in Wyndham, visit the Support Services webpage.

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