West Tamar Youth Outreach Service E-Referral

West Tamar Youth Outreach Service

The West Tamar Youth outreach Service is funded by the Irene Phelps Charitable Trust to provide a broad range of support to 12-25 year olds in the West Tamar region who live in Legana, Exeter, Beaconsfield and surrounding areas.

Support is provided via:
a) Individual therapeutic support at school, community centre or at headspace Launceston

b) Group facilitation and psychosocial educational sessions

c) Support to families and caregivers

d) Liaison with schools, service providers and other supports.

The West Tamar Youth outreach Service has a multi-focused approach; and can assist with:

Mental health and wellbeing
Connections with education and/or employment
Personal relationships, sexuality and gender identity
Strengthening relationships with family, friends and community

How to refer:
The West Tamar Youth Outreach Service accepts referrals and self-referrals from family members, GP's, schools and from other services and supports.

Please click "next" to make a referral.

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Young Person's Details:

First Name*

Last Name*

Date of Birth*

Gender*

Home Phone

Mobile Phone

Street Address*

Town/Suburb*

Postcode*

Is the young person Aboriginal or Torres Strait Islander? *

Yes

Does the Young Person require an interpreter? *

Yes

Preferred Language:*

Current Living arrangements (e.g. couch surfing, with parents, etc.): *

If a home visit is required, please outline any environmental hazards:

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Reasons for Referral:

Anxiety/Depression*

Yes

anx/dep specify*

Self-Esteem/Body Image*

Yes

self-esteem specify*

Behaviour*

Yes

Behaviour Specify*

Friendship Issues*

Yes

friendship specify *

Anger Issues*

Yes

Anger Specify*

Relationships*

Yes

Relationship specify*

Financial Concerns*

Yes

financial specify*

Past Trauma*

Yes

trauma specify*

Self Harm*

Yes

self harm specify*

Suicidal Ideation/Attempt*

Yes

suicide specify*

Drug/alcohol Misuse*

Yes

Drug/alcohol specify*

Sexual Health*

Yes

sexual specify*

Concerns at Home*

Yes

home concerns specify*

Disengaged from School/Employment*

Yes

school/employ specify*

Other*

Yes

other specify *

Additional Information

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Consent

Is the young person aware of this referral? (young person must consent for the referral to proceed)*

Yes

Additional contact person if we are unable to reach the young person:

Name:*

Phone*

Relationship to Young Person*

Consent to contact:*

Yes

Contact Notes (if applicable):

Referred By:

Your Name*

Your Phone*

Organisation/Role:*

Your E-mail*

How did you hear about the West Tamar Youth Outreach Service? *

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