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Referral Form

Ravine welcomes new referrals to our programme year-round. We take on self-referrals and 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 referral form below

Young Persons Details

(If self reffering please skip next section and click the submit button)

The young person named above is referred by:

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