Referral Form – Employment Services (APM/FSE)

Referral Form, Employment Services (APM/FSE)

For referral of job seekers to Shrink & Co. for psychology, psychiatry, behaviour insights, and specialised assessments.

Referrer details

Date of referral*

Please select the date of referral.

Referring organisation*

First Sun Employment APM – Gold Coast APM – Wivenhoe

Please choose the referring organisation.

Which referring location?*

Please choose the referring location.

Please specify the referring location*

Please specify the location.

Which referring location?*

Please choose the referring location.

Please specify the referring location*

Please specify the location.

Where is the desired location for the appointment to occur?

Telehealth only from April 2026.

Telehealth (including Outreach) Other

Please specify the desired location

What service is this referral for?*

Select all that apply.

Please select at least one service.

Please specify the other service

Select the Specialised Assessment(s) you seek*

Select all that apply.

Has the participant given consent to the referral?*

Yes No – please obtain consent prior to referral

Please confirm participant consent.

Do you want to book the client directly into an available slot now?*

There is a higher likelihood of engagement if you can offer the appointment day and time on the spot. You can book just before their Shrink & Co. appointment to help attendance at both. This applies to Psychology only.

Yes – a booking calendar will appear below No – we will contact the participant directly to arrange the appointment

Please choose a booking option.

Book the appointment now

Select an available time in the First Sun Employment booking calendar below.

Referral details

First Sun Employment – confirm session approval

Select all that apply.

Sessions approved – Psychology Sessions approved – Psychiatry Sessions approved – Behaviour Insights Team (includes all Allied Health) Sessions approved – Specialised Assessment

Psychology – PULSE expenditure numbers*

Please create 6 separate expenditures in PULSE, one per appointment, and enter each number below.

Please enter all six Psychology PULSE numbers.

Psychiatry – PULSE expenditure numbers*

Please create 6 separate expenditures in PULSE, one per appointment, and enter each number below.

Please enter all six Psychiatry PULSE numbers.

Behaviour Insights Team (BIT) – PULSE expenditure numbers*

Please create 6 separate expenditures in PULSE, one per appointment, and enter each number below.

Please enter all six BIT PULSE numbers.

Specialised Assessment – EXP number*

Please enter the Specialised Assessment EXP number.

What is the objective?*

Please describe the objective.

Participant details

Participant's full name*

Required.

Participant's primary contact phone number*

Mobile preferred, as SMS reminders are sent to the client 48 hours before the appointment.

Please enter a contact phone number.

Participant's secondary contact phone number

If available.

Participant does NOT have an email address

Participant's email address*

This assists us in contacting the participant.

Please enter a valid email.

Emails do not match.

Employment consultant's name*

Required.

Employment consultant's telephone (most direct line)*

Include direct extension number if available.

Please enter a phone number.

Employment consultant's email address*

Please enter a valid email.

Emails do not match.

Additional information

What is your desired outcome for the participant?*

Please provide your objective, e.g. prepare for work-readiness, reduced hours, IEA referral.

Please describe the desired outcome.

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