REFERRAL FORM

What program is best for you is a shared decision discussed with you through our referral process.

You can submit a self-referral or complete the referral with your Health Professional.

 

To submit a referral, please download the Referral Form, save to your computer, complete all sections and return to QEC via email, post or fax.

 

Email to:           Attach completed referral to your email and send to qecai@qec.org.au with ‘New Referral’ in the email subject line.

Fax:                   03 9549 2779

Post:                 QEC, 53 Thomas Street, Noble Park  VIC  3174

 

Click here to complete AI Referral form

 

A QEC Assessment & Intake Clinician will contact you within one working week between the hours of 8.30am – 4.00pm, Monday to Friday.

When the clinician calls, the number displayed on your phone will be (03) 9549 2777. If you are unavailable, please return the call at your earliest convenience.
 

 

NOTE:

If you have trouble accessing this form please call our QEC reception on 9549 2777 and we will arrange to send you one via email or post.

 

While waiting for your call please take the time to have a look at our: Parenting Advice, Stories, Audio Advice, Video Advice, and Podcasts on this site.

 

You can also call the MCH Line: 13 22 29

And visit the Raising Children Network website: http://raisingchildren.net.au/

 

 

HEALTH PROFESSIONAL REFERRAL FORM

 

If you would like to make a referral to Residential PASDS please complete the QEC PASDS Referral from below:

 

Click here to download the PASDS Referral form (word doc)

 

If you would like to make a referral to our Dandenong C2K Program please contact Genevieve O'Connor, Team Leader on Tel: 03 9701 3471.

 

GIPPSLAND SLEEP & SETTLING PROGRAM

 

Referrals to the Gippsland Sleep & Settling Program are to be submitted by health professionals from MCH Services in Baw Baw, Latrobe and Wellington shires.

 

To submit a referral, please download the Gippsland Sleep & Settling Referral Form, save to your computer, complete all sections and return to QEC via email.

 

Email to: Attach completed referral to your email and send to theqec@qec.org.au with ‘Referral Gippsland Sleep & Settling' in the email subject line.
 

Click here to complete Gippsland Sleep and Settling Program Referral form