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Client Details:
First Name: Last Name:
State: Post Code:
Postal/Shipping Address:
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State: Post Code:
Client Details:
DOB: Indigenous Status:
Gender: Country of Birth:
Living Arrangements: Child Protection Client Status:
Source Of Referral: Client Service Type:
Reason For Referral: Client Group:
Referral Date: dd/mm/yyyy Closed Date:
Counsellor: Reason for Closure:
Unprogressed: Drop-In:
Pre-School: Consent for Govt to Contact:
Highest Schooling: Receiving Centerlink?
Marital Status: Active?:
Who Received Service:  Client  Partner  Family  Friend  Parent/Carer
Phone: Mobile:
 Intellectual / Learning     None
 Not Stated / Inadequately Described     Other
 Physical / Diverse     Psychiatric
 Sensory / Speach 
Other Identified Issues:
 Aggressive Behaviours     Anger
 Anxiety     Attachment Disorder
 Bullying     Criminal Involvement
 Depression     Dissociation
 Domestic Violence     Drug / Alcohol Misuse
 Eating Disorder     Employment Problems
 Financial     Flashbacks
 Grief     Housing
 Interpersonal Relationships     Isolation
 Loneliness     Low Self-Esteem
 Mistrust     Nightmares
 Parenting Skills     Phobias
 Poor Impulse Control     Post - Trauma
 Problematic Sexual Behaviours     Revictimisation
 School Problems     Self Harming Behaviour
 Sexual Dysfunctions     Sexuality
 Sexually Abusive Behaviours     Sleep Disturbances
 Somatic Complaints     Suicidal Ideation / Behaviours
 Witness to Domestic Violence 
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Client Status:
 Improved Life Skills  Support Still Required
Therapeutic Interventions:

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Date: Mon, January 20, 2020 For: Case Work Time: 30  Edit
Notes: Closed case file

Date: Mon, January 20, 2020 For: Recording Data Time: 10  Edit

Date: Thu, December 19, 2019 For: Case Work Time: 60  Edit
Notes: Case Management meeting with Julie Stiles from Churches of Christ.Julie stated that she has been working with N for the past two months and has completed a case management plan that includes Phoenix House. PH has been stated as the preferred counselling service for this family. N would like all the children to attend the service for counselling and Bree is currently enrolled in Bumble Bees Program that commences in the New Year. Additional events were disclosed that have happened within the family unit and the involvement of Police and Child Safety have been regular over the past two months. It was suggested that a home visit be organised with N and PH to confirm support plan and counselling with children.- BW

Date: Mon, December 9, 2019 For: Case Work Time: 15  Edit
Notes: Tentative booking made for Natasha to attend stakeholder meeting today - she did not attend.-BW

Date: Thu, December 5, 2019 For: Case Work Time: 14  Edit
Notes: Received a call from Julie who stated that N is unwell and did not want to attend the stakeholder meeting today we discussed availability over the next two weeks Julie will inform me of another appointment. Awaiting contact.-BW

Date: Mon, December 2, 2019 For: Case Work Time: 30  Edit
Notes: Received a call from Julie at Working with Families, who requested a stake holder meeting for this family. Julie mentioned that N is struggling with all the children at home and there is relationship issues with N and her partner. I explained that the children have allocated counsellors and Brianna is enrolled into Bumblebees program or next year. Stakeholder meeting booked for 05/12 at 1pm at Phoenix House.-BW

Date: Fri, October 4, 2019 For: Parent/Carer Hours Time: 60  Edit
Notes: Home visit completed, N disclosed that she is doing ok but is struggling with all the other children due to their high needs and lack of sleep. N would like to have individual counselling for the children as they are displayed behaviours that she is not able to control. Intake form for Brianna for Bumble bees program for next year. Explained that they children's will be allocated to another worker and they will be in contact soon to make an appointment.-BW

Date: Wed, October 2, 2019 For: Phone Contact Time: 15  Edit
Notes: Attempt to contact Natasha on her mobile re: home visit. Counsellor left a voice message with a return number.

Date: Wed, October 2, 2019 For: Recording Data Time: 10  Edit

Date: Tue, September 10, 2019 For: Arranging Referrals Time: 20  Edit
Notes: Update database and client spreadsheet and raise outside referral letter. DBK

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Date: Tue, September 10, 2019 Action Reqired: No  Edit
Memo: IFS referral - Harding - Blossom Children.
Document:  View Document >>  

Date: Tue, September 10, 2019 Action Reqired: No  Edit
Memo: Outside referral letter - Harding Blossom
Document:  View Document >>  

Date: Tue, September 24, 2019 Action Reqired: No  Edit
Memo: Client reallocation to Catherine Welch. Phone contact with mother Natasha Livingstone who expressed concern with disclosure of sexual abuse from child, a request for one on one counselling preferable to group protective behaviors. Discussed case with Catherine Welch, Catherine to accompany to home visit to complete intake 4th October.

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