Centre for Play Therapy - Child Counselling

COVID-19 Update: C4PT now offering clinic based and online tele- play therapy sessions, contact 1300 424 752 to make an appointment - all referrals welcome

ALL ENQUIRIES 1300 424 752

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Phone Number: 1300 424 752
Email: enquiries@c4pt.com.au

This form is for agencies or families who would like to refer a child to Centre for Play Therapy.

If you have a general enquiry please hit the contact tab above.

Office you wish to enquire about

Refer Name (required)

Referring Agency (if applicable)

Referrer Contact Number (required)

Referrer Email Address (required)

Child's Name (required)

Child's DOB (required)

Parent/Carer Name (required)

Parent/Carer Contact Details

Does the child identify as an: Aboriginal/Torres Straight Islander/Other culturally or linguistically diverse background?

If Yes, please provide details

Is an interpreter required?

Is the family aware of this referral?

School details

Details of other family and/or household members including age and relationship to child

What key issues impact this family?

Behavioural, Mental Health and/or Emotional Wellbeing Concerns

Witnessing/Experiencing/Perpetrating Domestic and Family Violence

Physical Health and/or Disability Concerns

Family Conflict and/or Relationship Concerns

Social isolation

Substance abuse

Parenting Concerns

Financial Wellbeing Concerns

Homelessness

Other

If Other

Details of presenting issues/ behaviours of child/ children

Home
What is Play Therapy?
Our Team
Services
Training
Locations
Blog
Refer
Contact

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