Potential service delivery/request to use

WebPartZone1_1

PublishingPageContent

To access any of the centre's services and programs, please complete the online form below or download the print version.

Privacy statement

The Department of Education through Denise Kable Youth Services Centre is collecting personal information in accordance with Education (General Provisions) Act 2006 in order to receive enquiries regarding centre services. The information will only be accessed by Department of Education. The information will not be given to any other person or agency unless consent is provided.

Online form

WebPartZone1_2

Name

Date

Organisation

Position

Email

Mobile

Please select the target cohort/s of young people your service caters to.

Students and young people who have disengaged from education

Students and young people at risk of disengaging from education

Students and young people with challenging behaviours

Students and young people from culturally and linguistically diverse backgrounds

At-risk students and young people engaged with the Youth Justice system

At-risk students and young people within the child safety out-of-home care system

Please select the impacting issue/s on the target cohort of young people your service caters to.

Health (particularly mental health including access to specialised support services)

Substance misuse

Youth suicide prevention and postvention responses

Family and domestic violence

Housing and homelessness

Youth justice and support for young people returning from detention

Employment pathways including job readiness

Issues relating to indigenous cultural identity

Resettled refugee students impacted by significant trauma through exposure to civil unrest and war

Service provider

Type of service provided

Is telehealth an option for service delivery?

Yes

No

Is there a charge for the service provided?

Yes

No

Specify your own value:

Referral pathway into service

Service funded by

Who is the attending service?

Please indicate if you are Service provider staff | Parents/carers | Student/s and how many are attending.

Please detail supervision ratio/arrangements (if applicable)

Type of room requested

Consulting

Medical clinic

Meeting

Training

Intended room use

For example mental health support for young people.

Date and time requested from

Date and time requested to

Other supporting information or comments

WebPartZone2_1

WebPartZone2_2

WebPartZone2_3

WebPartZone3_1

WebPartZone3_2

WebPartZone3_3

WebPartZone3_4

WebPartZone4_1

WebPartZone5_1

WebPartZone5_2

WebPartZone6_1

WebPartZone6_2

WebPartZone7_1

WebPartZone7_2

WebPartZone8_1

WebPartZone8_2

Amenities

Potential service delivery/request to use

Privacy sta​tement​

Online form​​​​​

Privacy statement

Online form