Our Mental Health pages are undergoing changes between 5:00pm and 9:00pm on March 1, 2021. You may experience disruption while browsing the Mental Health pages during these times.

Mental health referral templates

 

 

PLEASE NOTE the cut off dates for referring your patients/clients to the Psychological Support Services (PSS) and Primary Integrated Care Supports Program (PICS) during the holiday period:

  • PICS:  Last date that referrals can be sent to the CESPHN will be COB Wednesday 23 December 2020.
  • PSS: Last date that referrals can be sent to the CESPHN will be COB Friday 11 December 2020.
  • Suicide Prevention referrals through PSS will be accepted up until COB Friday 11 December 2020.

PICS referrals will reopen on Monday 4 January 2021 and PSS referrals will reopen on Monday 11 January 2021

 

 

 

Mental HealthDate as atPDFWordBest PracticeMedical Director Online 
PSS – GP Initial Referral for adults and young people and children Mental Health Treatment Plan 25 June 2020  - Best Practice template download Medical Director template download 2019015 icons 22
PSS – GP Review Referral for adults and young people and children Mental Health Treatment Plan 25 June 2020  - Best Practice template download Medical Director template download 2019015 icons 22
Resources - Depression, Anxiety, and Stress Scales (DASS 21) 24 September 2019 PDF document download Microsoft Word document download Best Practice template download Medical Director template download  
Resources - Health of the Nation Outcome Scale (HoNOS) Refer online Best Practice template download Medical Director template download   
Resources - Edinburgh Postnatal Depression Scale (EPDS) 24 September 2019 PDF document download - Best Practice template download Medical Director template download document
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Resources - Kessler Psychological Distress Scale (K10) 24 September 2019 PDF document download - Best Practice template download Medical Director template download  
Resources - Kessler Psychological Distress Scale (K10+) 24 September 2019 - - Best Practice template download Medical Director template download   
Services Referral - Black Dog Insitute Referral Forms for Clinics Download forms from hospital's website
Services Referral - headspace Ashfield 24 September 2019 Microsoft Word document download - -  
Services Referral - headspace Bondi Junction 24 September 2019 PDF document download  -  -  -  
Services Referral - headspace Camperdown 24 September 2019 PDF document download  -  -  -  
Services Referral - headspace Hurstville  24 September 2019 Microsoft Word document download Best Practice template download Medical Director template download  
Services Referral - headspace Miranda 24 September 2019 PDF document download  -  -  -