If you have a client you would like to refer to CAPS Talk Suicide Support Service you can do so by either following the link below to download the form, complete and return to support@talksuicide.org.au, or alternately you can complete the submit the form online by completing the details below.

Please note – Prior to referring, please ensure that you are aware of the services that CAPS Talk Suicide Support Service provides and its relevance to your client. In addition, please ensure you have obtained your clients consent to refer them to our service.

Download TSSS Referral Form (PDF)

Talk Suicide Support Service Referral Form

Consent: the person being referred must consent to this referral.

By ticking this box, I confirm I have discussed this TALK SUICIDE Support Service referral with the person being referred, and they consent to this referral. They understand that this may include contacting me (the referrer) for further information.

 The person is presenting with suicidal thoughts and/or behaviours The person is 15 years or older

Date of referral :

Details of Individual being referred:

Sex:  Male Female Other

DOB :

 Ok to leave message

Does the client identify with any of the following (tick all appropriate)

 Aboriginal or Torres Strait Islander LGBTQIA Refugee Living with a Mental Illness Living with an Intellectual or Physical Disability Non English Speaking Background Requiring an Interpreter

Referrer’s details:

 Is the individual currently receiving support from your organisation

Client Background Information

Other relevant information

To enquire further about TSSS, call 1800 008 255. You can talk directly with one of our Case Managers who will guide you through the referral process, or can assist you with alternative referral options if TSSS is not appropriate.
Submit the form above or alternatively feel free to download the application form and send it in via mail to support@talksuicide.org.au