Referral Form

Ravine welcomes new referrals to our programme year-round. We take on referrals from health professionals, key workers, agencies or organisations working with young people experiencing mental health challenges.  


Could Ravine be a potential match for you or a young person you know?


Register your interest by completing our online form below

Young Persons Details 


If you are completing the referral on behalf of the young person above please complete the details below.