Psychology Referral Form

Once you have completed the form please email it back to admin@steps2lifecare or if you have any questions or
need support filling this form out, please call us on 02 9638 3362 .

Please allow for 3 business days for your referral
to be processed.


Important information regarding your referral, please read

Please note that we are not and emergency service. If the client is at high or acute risk of suicide, please contact emergency services on 000 or attend your nearest hospital emergency department.

We make every attempt to see clients referred for services at Steps 2 Life. If it is determined that we are not able to support the client’s needs, we will advise you of this as soon as possible and will attempt to refer you to a more suitable service.

When completing the referral, could you please provide any relevant assessments, reports, and/or additional information you may have regarding the client.

    Type of Mental Health Support
    Please tick all that apply and provide further details

    Referrer Details : Steps 2 Life will be corresponding with you using the below details. Please ensure that all details are fully completed.

    Parent / Guardian/ Next of Kin Details

    Do we have permission to speak with the client?

    Client Details

    Does the client have a Mental Health Care Plan?

    Does the client have a NDIS plan with funding for Psychology services?

    Please complete the following questions with as much details as possible

    Urgent Concerns: