Refer a Client to Life Mental Health

Use the form below to refer an adult, young person or NDIS participant for therapy, DBT programs or psychosocial support. We'll follow up within two business days.

We accept referrals from GPs, psychiatrists, hospital and community mental health teams, support coordinators, recovery coaches, PHN-funded and NGO services, private clinicians and schools. If you're unsure about suitability, contact us before submitting.

Your Details

Full name *

Role / Profession *

Organisation

Phone *

Email *

Client Details

Client first name *

Client last name *

Date of birth *

Client phone

Client email

Is the client aware of this referral? *

YesNoPartial