CASA Central Victoria
03 5441 0430
(Mon to Fri, 9am-5pm)
Sexual Assault Crisis Line
1800 806 292
all other times
CASA Central Victoria
03 5441 0430
(Mon to Fri, 9am-5pm)
Sexual Assault Crisis Line
1800 806 292
all other times

Referral forms

To heal, you need to be heard

 Life can change when you talk to someone who listens and responds with respect and care.

One of the most common referral is from the person who has experienced sexual assault. A person can contact CASACV by calling our Intake and Counselling Team on 5441 0430 to discuss your needs and how we can help. During this conversation you will be asked a series of questions, to allow us to understand the assistance needed. This process can take up to 30mins.

Alternatively, you can complete the self-referral form below and one of our Counsellor /Advocates will call you. Please note that CASACV calls from a private phone number. The self-referral form on this page allows you to easily refer yourself.

For a service provider please use the referral form appropriate to a child or adult referral. Please contact CASACV on 5441 0430 if you have any queries regarding the completion of these forms.

If you run out of time to complete a form, use the “Save Form and Complete Later” link at the bottom to generate a unique link that you can email to yourself to return and complete it later.

Please note CASACV delivers services to people living in suburbs within the Loddon Campaspse Region – please check the CASACV Post Code and Suburb Directory below to ensure we service your area.

CASACV Suburb and Postcode Directory

 

Or go to the CASA Forum website for the CASA that services your area.

https://www.casa.org.au/contact-us/find-your-nearest-casa/

Self referral

Referral (adult)

Referral (children & adolescents)

Referral (DHHS child protection)

Referral - REFOCUS