Student Self Referral to the School Counselling Team
Please note: This link is only monitored during school hours (8.30am - 3.30pm).

If you or someone you know is in immediate danger please call 000.

Please complete the form below for confidential self referral to the School Counselling Team. One of our team will contact you within two school days to arrange follow up. During remote learning, sessions are via phone or online link that will be sent to your school email.

School Counsellors:

TBA                   (Mon/Tue/Wed)
Andrea Smith   (Thur/Fri)

Other telephone and online services are listed below:

Kids Helpline on 1800 55 1800, or at https://kidshelpline.com.au/
Lifeline on 13 11 14 or at https://www.lifeline.org.au/ 
headspace on 1800 650 890 or at https://eheadspace.org.au/


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Email *
Name (First and Last) *
Year Group *
Talking with the school counsellor is confidential unless there is a safety concern. If you or someone else is at risk of harm, the school counsellor will need to speak to your emergency contact and/or parents/guardian, and the school principal to ensure everyone is safe.                                      Do you understand? *
Please provide emergency contact details  (name, phone number, relationship). This person must be in the location you are calling from, but does not need to be in the session *
Preferred day *
Required
How soon do you need to speak to someone? *
NOTE: This mailbox is monitored during school days/hours from 8.30am-3.30pm. If the matter is urgent, please contact 000 or refer to other online and telephone support services listed at the top of this form.
Please provide a brief summary of the reason for referral. *
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