Online referral

Referral to Tweddle

Your referred family will now be contacted for an intake assessment where we will discuss their needs and establish the level of vulnerability and risk.  We will keep you informed of your client’s admission/non admission and outcomes.  Please contact us on (03) 9689 1577 if you would like to speak to a member of our clinical team.

 

Referral Details

Family Details

Parent 1 (primary contact)

Parent 2

Marital Status: (required)

Primary Care giver (if different to parent)

Child

Sibling(s)

Add Sibling

Does the parent require an interpreter and if yes, what language?

Significant Family Members/Other

Primary contact

Secondary contact

Other Services Currently involved with family

Add Service

Criteria for entry into an Early Parenting Centre

This family has:

One or more children under 4yrsCurrent involvement with Child ProtectionCurrent involvement with Child FirstAboriginal/Torres Strait IslanderRefugeeCALD (Cultural and Linguistic Diversity)

Please indicate area of parenting challenges (tick one or more of the following):

Meeting child's emotional needsMeeting child's social needsMeeting child's physical needsMeeting child's cognitive intellectual needs

How does the parent perceive the parenting difficulty?
(it is important to know what the parent feels in order to commence the process)

Child Risk Factors:
(tick one or more of the following child specific risk factors)

Feeding concerns impacting on healthChallenging BehaviourChronic illnessMore than 5wks PrematureDisability2500gms at birthDevelopment concerns

Comments:

Parental Risk Factors:
(tick one or more of the following parent specific risk factors)

Physical DisabilityIntellectual DisabilityChronic illnessSubstance misuseHomelessnessMental illnessAn offending patternTeenage parentingFamily ViolenceSingle Parent without supportHistory of abuse/neglect as a childSevere budgeting and financial difficultiesPrevious Child Protection involvement with other childrenLow educational attainment - less than year 9

Provide details of risk factor/s and observed impact on parenting:


I agree that this referral has been discussed with the parent, and the parent has agreed to the referral.


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