This form is for referrals for people who are no longer in high school education and require help for their drug and/or alcohol issues. If this is a referral for someone else, they must ask their consent for the referral to be made prior to filling this in.
If you are filling in this form for someone else, please do so with the person that you are going to refer. Please remember this referral is for counselling. It is not an emergency or crisis service. If the person is expressing a wish to die and says that they have a plan of what to do, you must ensure that they attend the local Emergency Department as soon as possible.