headspace is a service for young people aged 12-25, providing free, youth friendly and confidential service. We can only engage with young people who have provided consent to the referral. headspace Port Augusta is not a crisis service, and should you have any concerns, if the young person is in crisis, or if they are at an acute risk of harming themselves or others, please contact emergency services on 000. In a mental health emergency please contact Mental Health Triage on 131465. Please note the receipt of the referral form does not indicate acceptance to headspace Port Augusta services. Suitability of the referral will be determined following assessment with the young person. Waitlist- given the demand for headspace services, there may be a waitlist at times. You will be advised by a headspace staff member via phone call or letter. We request that you seek urgent help from your GP or local hospital should your situation change. We recommend a list of services including eheadspace and Beyond Blue.

(What are the current issues? Please include info about the duration, age of onset and pre-existing diagnoses. Please attach further information/relevant assessments, reports etc. in box below)

Please check the appropriate boxes below