(03) 9481 3000 FollowFollowFollowFollow Donate Home About Our Vision Our Board & Executive Join Our Team Our Work Support Services Family Violence Settlement Casework Community Programs Parenting Settlement Young Women Leadership Training & Consultation Research & Policy Resources English Mental Health Islamophobia & Discrimination Family Violence Early & Forced Marriage Annual Reports Other Dari Arabic Farsi Other Events News & Media Feedback Action for Palestine & Sudan Contact Strength in diversity Book a Secondary Consultation Booking details Choose Online or Phone consultation below Need a longer appointment? Select up to 4 time slots to create a longer appointment, (e.g. 1 slot = 15 mins, 2 slots = 30 mins, 4 slots = 60mins)Booking details Location Online consultationPhone consultation Service Category Secondary Consultation Service Secondary Consultation Please specify agenda Staff AMWCHR Client Services Timezone: Australia/Melbourne July 2025 MON TUE WED THU FRI SAT SUN 12345678910111213141516171819202122232425262728293031 Consultation TypeDirect person consultationPractitioner consultationName(Required) First Last Email(Required) Phone(Required)Direct Client Secondary ConsultationClient – Victim SurvivorClient – Person using ViolenceFamily MemberFriendCommunity MemberYoung Person under 17 years oldPrimary Client's Date of Birth DD slash MM slash YYYY Gender of primary clientFemaleMaleNon-binaryCultural backgroundPrimary client's country of birth (If known) (optional)Language spoken at home (If known) (optional)Visa Subclass / Immigration Status1. Student Visa (Temporary)2. Provisional Partner Visa (Temporary)3. Safe Haven Enterprise Visa SHEV (Temporary)4. Bridging Visa (Temporary)5. Visitor Visa (Temporary)6. Skilled Migration Visa (Temporary)7. Refugee/Humanitarian Visa (Permanent)8. Refugee/Humanitarian Visa – Women at Risk (Permanent)9. Orphan Relative Visa (Permanent)10. New Zealand Citizen – Special Category Sub-Class 444 Visa11. Australian Citizen12. Unknown13. OtherBriefly describe reason for consultationPractitioner Name:(Required) First Last Practitioner Email(Required) Practitioner Phone number(Required)SectorAdult correctional facilityAged care serviceCentrelink or employment services case workerChild protection agencyCourtsDisability support serviceDon't knowDrug and alcohol serviceHospitalImmigration department or asylum seeker/refugee support serviceLegal unit (including Legal Aid)Mental health serviceOther agency (government or non-government)Other Family and child support agencyPoliceSchool/other education institutionSocial housingSpecialist Homelessness Agency/outreach workerTelephone/crisis referral agencyYouth or juvenile justice correctional centreSelect serviceConsultation without client recordOrange door secondary consultationFamily Violence Integrated Services secondary consultationHave you received the client's consent? Yes No The Orange Door LocationsBroadmeadows 1093 Pascoe Vale Broadmeadows VIC 3047 1800 271 151 hma@orangedoor.vic.gov.auCranbourne 23 High Street Cranbourne VIC 3977 1800 271 170 sma@orangedoor.vic.gov.auDandenong 311 Lonsdale St Dandenong VIC 3175 1800 271 170 sma@orangedoor.vic.gov.auEpping 571-583 High St Epping VIC 3076 1800 319 355 nema@orangedoor.vic.gov.auHeidelberg 56 Burgundy St Heidelberg VIC 3084 1800 319 355 nema@orangedoor.vic.gov.auMelton 222 Ferris Rd Melton South VIC 3338 1800 271 046 bma@orangedoor.vic.gov.auPakenham 48 John St Pakenham VIC 3810 1800 271 170 sma@orangedoor.vic.gov.auShepparton 210 Corio St Shepparton VIC 3630 1800 634 245 goulburn@orangedoor.vic.gov.auSunshine 15-19 Service Street Sunshine VIC 3020 1800 271 046 bma@orangedoor.vic.gov.auWerribee 15-17 Watton St Werribee VIC 3030 1800 271 045 wma@orangedoor.vic.gov.auPrimary Client's Name First Last CRIS or Tenancy ID number (for primary client)Primary client’s date of birth DD slash MM slash YYYY Gender of primary clientFemaleMaleNon-binaryPrimary client’s Cultural BackgroundPrimary client’s country of birth (If known) (optional)Primary client’s languages spoken at home (If known) (optional)Visa Subclass/Immigration Status1. Student Visa (Temporary)2. Provisional Partner Visa (Temporary)3. Safe Haven Enterprise Visa SHEV (Temporary)4. Bridging Visa (Temporary)5. Visitor Visa (Temporary)6. Skilled Migration Visa (Temporary)7. Refugee/Humanitarian Visa (Permanent)8. Refugee/Humanitarian Visa – Women at Risk (Permanent)9. Orphan Relative Visa (Permanent)10. New Zealand Citizen – Special Category Sub-Class 444 Visa11. Australian Citizen12. Unknown13. OtherPrimary reason for referralRisk assessment and risk mitigationChild and young person safety concernsParenting Capacity concernsForced marriage and modern slaveryRacism and islamophobiaMental Health (Cognitive Capacity)PhysicalSafety planning, including community safety planningOther primary reasonsSecondary reason for referralAt risk of evictionCross-cultural communication and mediationCultural Assessment and/or planningFamily ViolenceForced MarriageLanguage ServicesMigration or legal matters (general)Migration or legal matters (RoS Visa for SHEV or TPV holder/s)Migration or legal matters (Citizenship)ParentingPlacement PlanningReferral pathwaysSpecialist Cultural advice or supportOtherOther reasons for referral (if not listed above in the primary/secondary reasons for referral) (optional)Current presenting issues or challengesPhoneThis field is for validation purposes and should be left unchanged.EmailThis field is for validation purposes and should be left unchanged.NameThis field is for validation purposes and should be left unchanged.NameThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.EmailThis field is for validation purposes and should be left unchanged.PhoneThis field is for validation purposes and should be left unchanged.NameThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.Intervention & Order in placeSafety Notice/Family Violence Interim Intervention Orders:Interim Accommodation OrderParenting OrderCompulsory treatment ordersEviction OrderEmailThis field is for validation purposes and should be left unchanged.PhoneThis field is for validation purposes and should be left unchanged.EmailThis field is for validation purposes and should be left unchanged.NameThis field is for validation purposes and should be left unchanged.EmailThis field is for validation purposes and should be left unchanged.EmailThis field is for validation purposes and should be left unchanged.EmailThis field is for validation purposes and should be left unchanged.PhoneThis field is for validation purposes and should be left unchanged.PhoneThis field is for validation purposes and should be left unchanged.EmailThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.EmailThis field is for validation purposes and should be left unchanged.NameThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.EmailThis field is for validation purposes and should be left unchanged.NameThis field is for validation purposes and should be left unchanged.PhoneThis field is for validation purposes and should be left unchanged.PhoneThis field is for validation purposes and should be left unchanged.PhoneThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.EmailThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.NameThis field is for validation purposes and should be left unchanged.EmailThis field is for validation purposes and should be left unchanged.NameThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.NameThis field is for validation purposes and should be left unchanged.EmailThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.EmailThis field is for validation purposes and should be left unchanged.PhoneThis field is for validation purposes and should be left unchanged.NameThis field is for validation purposes and should be left unchanged.NameThis field is for validation purposes and should be left unchanged.PhoneThis field is for validation purposes and should be left unchanged.CommentsThis field is for validation purposes and should be left unchanged.EmailThis field is for validation purposes and should be left unchanged.NameThis field is for validation purposes and should be left unchanged.PhoneThis field is for validation purposes and should be left unchanged.PhoneThis field is for validation purposes and should be left unchanged. 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