Youth Engagement Team Referrals

 

We welcome enquiries from service providers, health professionals, and young people. Please note that we do not hold a waitlist, so we encourage you to contact our Triage Team to check current availability before submitting a referral.

Referrals can only progress if the young person is aware of the referral, gives their consent, and is available to speak with our triage team.

All referrals are responded to within three business days. Please note that we are not a crisis service.

Lets get started

Date of Birth 
Can we use your preferred name when speaking with other people, for example parents/caregivers?
Gender
Home address
Postal address: (leave blank if same as above)
Does the young person identify as Aboriginal or Torres Strait Islander? 
Do they require an interpreter?

Emergency Contact (must be 18 years and over)

Current Support (if applicable)

If the young person is under 16, are their parents or carers aware of this referral?
In the last 6 months have they received support from any other services? CYMHS, ACMHS, CATT etc.

Questions on Risk

Please answer the following questions in relation to risk.

Risk of harm to self? (including frequency/duration of Deliberate Self Harm, Suicidal Ideation and behaviour as well as any previous hospital presentations or admissions) 
Risk of harm to others? 
Is there a current risk assessment or safety plan? (attach to referral) 
Are there any other risks we need to be aware of? 

Referrer Information

Will you have continued contact with the young person? 

Consents

Referral been discussed with the young person? 
Young person has consented to the referral? 
Has the referral been discussed with the Parent/Caregiver (if relevant)? 

Primary diagnosis/presenting problem/history)

Diagnosing Clinician (approx. date of diagnosis)
Current Outcomes Measures (eg SDA, K10, SOFAS, HoNOS/CA – Provide any that apply)
MeasureScoreDate Administered

Cornerstone Youth Services acknowledges and pays respect to the Tasmanian Aboriginal Community as the traditional and original owners, and continuing custodians of this land on which we gather today and acknowledge Elders – past and present.