Youth and family support service referral

Use this form to refer a young person (aged 10 to 17 years) and their family to our youth and family support service.

We can help young people who are at risk of breaking the law only if they live in or visit the Brisbane region.

To refer a young person and their family, answer the following questions and submit your referral online. Once we receive your referral, we will contact the family to set up a meeting and work out how we can best support them.

Required fields are marked with an asterisk (*).

Can I make a referral?
  1. Are you or are you concerned about a young person aged 10 to 17 years? *
  2. Does the young person live in, or regularly visit, our service area? * (If you chose ‘Yes’ above)

    View list of service areas in the greater Brisbane region

  3. Does the young person have a youth justice caseworker? * (If you chose ‘Yes’ above)
  4. Do you think the young person is at risk of engaging in a criminal act? * (If you chose ‘No’ above)

Our support service is only for young people aged 10 to 17 years and their family and support network.

The young person may be eligible for support from other services such as Kids Helpline, Parentsline, Child Safety regional intake, or Child Safety after hours service.

Make your referral

  1. The situation
    1. What are the issues the young person is experiencing? Select all that apply
    3. Is the young person getting support from other agencies? *

  2. Young person's details

    1. Young person’s name
    2. dd/mm/yyyy

    3. Home address
    4. Home, mobile or work number
    5. Example: jane.smart@example.com
    7. Have you received consent from the young person? *
    8. Does the young person need a translator? *
    10. Are you referring a second person from the same family? *

  3. Second young person

    1. The situation
      1. What are the issues the young person is experiencing?
      3. Is the young person getting support from other agencies? *

    2. Young person's details

      1. Young person’s name
      2. dd/mm/yyyy

      3. Home address
      4. Home, mobile or work number
      5. Example: jane.smart@example.com
      7. Have you received consent from the young person? *
      8. Does the young person need a translator? *
      10. Are you referring a third person from the same family? *

  4. Third young person

    1. The situation
      1. What are the issues the young person is experiencing?
      3. Is the young person getting support from other agencies? *

    2. Young person's details

      1. Young person's name
      2. dd/mm/yyyy

      3. Home address
      4. Home, mobile or work number
      5. Example: jane.smart@example.com
      7. Have you received consent from the young person? *
      8. Does the young person need a translator? *

Parent / Guardian details

  1. Referrer’s name

  2. Address
  3. Home, mobile or work number
  4. Example: jane.smart@example.com
  6. Have you received consent from the parent/guardian? *
  7. Does the parent / guardian need a translator? *

Referral details

  1. Referrer’s name
  3. Home, mobile or work number
  4. Example: jane.smart@example.com

Last reviewed:04 August 2026

Last modified:04 August 2026

Creative Commons Attribution 4.0 International (CC BY 4.0) licence This work is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) licence