This online form may be used by practitioners to refer eligible clients to inTouch for specialist inLanguage, inCulture family violence co-case management services.

Referrals for case management services should occur through a warm or supported process to maximise the likelihood that the client will take up the service and support being offered. It is expected that the referring professional/agency will remain engaged with the client until they have been allocated and a joint action plan has been developed.

Note – during COVID-19 our client eligibility criteria remains the same and can be viewed here.

If you are a woman experiencing family violence please use our Self-Referral Form to request support from inTouch.

Details of person requesting referral












Details of client
















*Please inform the client that all calls from inTouch will appear as a private/unknown phone number.











Client Consent

Submitting this form will send a new client intake request to inTouch.