This online form may be used by practitioners to request a specialist secondary consultation from an inTouch family violence case manager.

Please note: the majority of our case managers work part-time. It may take several days for the most appropriate case manager to respond to your query. If your query is urgent, please indicate it in the form or phone 1800 755 988.

Details of person requesting secondary consult









Client details








Key Presenting Issue for Discussion
Please indicate what is the nature of your inquiry and what support you are requesting from inTouch. *

Submitting this form will send a request for secondary consultation to inTouch.