Self-Referral Form - The Kids Hub

Book an Appointment

Parent/carer name:

Suburb:

Child's name:

Child's date of birth: (dd/mm/yy)

Preferred method of contact

Email
Mobile/phone call
SMS

Preferred day and time to contact you

Is it safe for us to contact you and leave a message on these details

Are there any safety concerns we need to be aware of

I need a translator

to to your

By completing the above, you consent to the Kids Hub storing this information and agree to a Care Navigator from the Kids Hub contacting you.

The Kids Hub welcomes walk-ins. We're open Monday to Friday from 8 AM to 7 PM and on weekends from 9 AM to 3 PM (The Stan and Jean Perron Child, Youth & Family Centre, 1 Watertank Way, Midland).

Mon - Fri: 8am - 7pm | Sat & Sun: 9am - 3pm

Book an Appointment

The Kids Hub is jointly funded by
the Australian Government and
the Western Australian Government.

Book an Appointment

Please be advised that we are not a crisis mental health service. If this is an emergency or someone else needs immediate attention:

If you have concerns about your child’s behaviour, development, mental health, and well-being, we have professionals who can support you with this.

7 days a week: Mo-Fr: 8am - 7pm | Sa - Su: 9am - 3pm

If you need to speak to someone outside our open hours:

Mon - Fri: 8am - 7pm | Sat & Sun: 9am - 3pm

7 days a week:
Mo-Fr: 8am - 7pm | Sa - Su: 9am - 3pm