Make a Referral

At Northshore Kidspace, we understand families are often time poor. While we encourage you to contact our Admin staff with any questions or concerns, if you are calling to make a referral we have simplified this process for you below!

To make a referral to a Doctor or clinician at Northshore Kidspace, we respectfully request the parents and/or patient complete a short Patient Information Form below. This allows us to understand your needs better, and provides information to your chosen Doctor or clinician with speed and accuracy.

Once complete, your information is then forwarded to your nominated team member. If you do not nominate a specific Doctor or clinician it will be forwarded to our Principal Psychiatrist or Psychologist who will endeavour to match your concerns with a team member experienced in that area.

Please note that filling out and completing this form does not guarantee access to treatment with a Northshore Kidspace clinician. Our clinicians assess referrals dependent on various factors including their experience in that clinical area, along with their clinical capacity at the time.

Confidentiality cannot be guaranteed, as email is not a secure medium. If you complete this form and return it to Northshore Kidspace, it may contain private or confidential information. If you believe you may not be the intended recipient of this form, or if you have received this form in error, please contact the sender immediately and delete all copies. If you are not the intended recipient, you must not reproduce any part of this form or disclose its contents to any other party.


Please note that Northshore Kidspace is not a crisis service. Northshore Kidspace is not able to respond immediately to either an email or referral form requesting a service. The Northshore Kidspace administrative staff check their email periodically, but do not maintain 24-hour access to email accounts. Life threatening matters should be directed to your nearest Hospital Emergency Department or Emergency Services on 000.

Please select which type of referral you wish to make: