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 Referral Form

Please note: We are a private, fee-for-service practice, we accept NDIS (self & planned managed).  We do not accept Medicare or Mental Health Care Plans. By submitting this form, you confirm you understand our fee structure.

Please Note: We offer out-reach services in the Onkaparinga & Marion Council areas. Telehealth appointments available on request for those outside these areas.

Confidentiality: All information provided in this form is kept strictly private and confidential. Your details are used solely to assess your needs and explore suitable support options. We will never share your information without your permission unless required by law to ensure safety.

 ©Coastal Edge Youth Services, Adelaide, South Australia, 2025. All Rights Reserved.

Coastal Edge Youth Services acknowledges that we are living on the traditional lands of the Kaurna people and pay our respects to Elders past and present. We acknowledge Aboriginal and Torres Strait Islander peoples’ spiritual connection to country and respect their relationship to their land, community and culture.

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