STOP - Referring yourself or a friend/family member? Please use the Self Referral Form.
This form is designed for you to refer a client/patient to headspace Launceston or headspace Devonport.
Please note: headspace Launceston and headspace Devonport are not acute mental health services or crisis services. If you have concerns for a person's immediate safety please contact the Mental Health Helpline on 1800 332 388. For urgent medical assistance please call: 000.
Privacy is important to us. This info will be kept confidential and used only to provide the best care possible. Please read the headspace 'Just between us' confidentiality statement.
Young Person Details
We are unable to make contact with them if the answer is NO.
Emergency Contact/Next of kin - MUST BE OVER 18
Reason For Referral