Step 1 - Register child / young person*

COMPLETE THE DETAILS FOR CHILD/YOUNG PERSON*

IMPORTANT:  Enter information in a continuous line. 

Use your cursor or TAB to the next item and do not use ENTER

Need to print this form?  Click here for printer-friendly pdf version

Hint:  Enter information in a continuous line.  Use your cursor or TAB to the next item and do not use ENTER

Parent / Carer SDQ form

Please note, the SDQ form above cannot be completed online.  Scan your completed form and email it securely to:  

Your Referral

COMPLETE THE DETAILS OF YOUR ISSUE OR CONCERN

Hint:  Enter information in a continuous line.  Use your cursor or TAB to the next item and do not use ENTER

Teacher / Referrer SDQ form

Please note, the SDQ form above cannot be completed online.  Scan your completed form and email it securely to:  

Hint:  Enter information in a continuous line.  Use your cursor or TAB to the next item and do not use ENTER

Additional information

Upload additional supporting documents and your comments below

Share your comments or additional information, especially if this differs from the referral details above, eg. how does this child present in other settings