Parent Referral Form-Pastoral Care
If you have concerns about the well-being of your child at school and would like some support from our team, please fill out this form and a member of our Pastoral Care Team will contact you. If the matter is urgent, please contact the school and ask to speak to Kristy Robb.
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Date *
Name *
Teacher *
Name of Referrer *
Does your child identify as Indigenous? *
Does your child have a Personalised Plan? *
Please give details of any specialists your child is seeing
If there is an existing diagnosis, please provide information otherwise mark as N/A *
Detailed reason for referral *
Has this concern been discussed with your child's teacher? *
Details of conversation with the teacher if applicable *
What is the desired outcome from contact with the Pastoral Care Team? *
Thank you for your referral. A member of our Pastoral Care Team will contact you shortly.
**Pastoral Care Team Administration Section**
Plan of Action
Closing Date
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