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 it I

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

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 on Tuesdays from 9:30am to 12:30pm and Wednesdays from 2:00pm to 5:00pm. All other times are available by appointment only (The Stan and Jean Perron Child, Youth & Family Centre, 1 Watertank Way, Midland).

Walk-ins: Tue 9:30 am - 12:30pm, Wed: 2:00pm - 5:00pm |
Appointments outside hours by booking

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 - Thu: 8am - 7pm | Fri: 8am - 4:30pm

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