Staff and Parents: Student Wellbeing Referral Form
If you would like to get in contact with us directly, please e-mail the Heritage College Wellbeing Team at: wellbeingteam@heritagecollege.vic.edu.au

This form is for parents, staff and administration who would like to refer students to the Heritage College Student Wellbeing | Wellbeing Coordinator (Miss Elsa Cangy). Please put in as much information as possible or rather state 'ref. to SEQTA' if you (staff member) have made entries there.

Please note that my position here is in youth support/pastoral care (not counseling, however I do make referrals to counseling services), for more information please refer to the school website or the Wellbeing Consent Form which can be attained at the administration office. Please also note that the Wellbeing Consent forms are for parental information and consent for their child to access this service only and not to be used as a referral form. The Wellbeing Student Referral Form must be filled out if a referral is also requested.

Wellbeing Days:

Officer Campus: Tuesday | Wednesday | Thursday (half day)
Narre Warren South Campus: Monday | Thursday (half day)

If this is an emergency please don't hesitate to contact the following services:

Child First: 9705 3939 (Southern Metro)
Child Protection: 8765 5444
Victoria Police: 9705 3111 (Narre Warren) | 5945 2500 (Pakenham)
Child Protection Reporting Step-by-Step guide below:

Email address *
Reporting Step by Step Guide p.1
Reporting Step by Step Guide p.2
Please enter your name (person making the referral) below *
Your answer
Are you referring on behalf of someone else? *
If so, please enter their name and contact details below
Your answer
Student Name *
Your answer
Student Year Level *
Your answer
Relation to Student (if this on the behalf of another person, select their relation) *
Required
Reason(s) for referral (if there is a SEQTA entry, please indicate that below instead) *
Your answer
Has this incident/student been reported to Child Protection and/or Victoria Police (if applicable)? *
Any additional information that you think might be helpful? (i.e. any information not entered in SEQTA yet)
Your answer
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