Bereavement Support Professional Referral Form
Please use this referral form to refer a client or family to the Red Nose Bereavement Support Service.
On completion of this form, a member of our Intake Team will contact the individual or family to explain our services and offer support. Please ensure that the individual or family you are referring has given their permission to be contacted by the Red Nose Bereavement Services Team.
If you are not a health professional, you can access support by calling us on 1300 308 307.