Dardi Munwurro
Welcome to Dardi Munwurro
Date referral completed:
Date Of Birth:
HAVE YOU PREVIOUSLY HEARD OF DARDI MUNWURRO PRIOR TO NOW YESNO
IF YES, HAVE YOU ATTENDED ANY OF OUR PROGRAMS OR SERVICES? YESNO
HAVE YOU EVER ATTENDED A RESIDENTIAL PROGRAM BEFORE? YESNO
IF YES, PROVIDE DETAILS:
The client is: Aware of, and understands, the program requirements.Committed to making positive changes and creating a positive vision for the future.Is currently double vaccinated, or willing to be vaccinated for COVID-19.
The client is willing to: Reside at Ngarra Jarranounith Place for up to 16 weeks.Provide two alcohol and drug screens as part of the intake process.Actively participate in all aspects of the program, including group activities and volunteering.Contribute $270 per fortnight of their Centrelink payment or equivalent to cover rent, utilities and meals.Consent to a follow up period of 12-18 months.Work with the Program’s Family Engagement and Safety Worker who will be supporting affected Family members.
Does the client have any of the following:
Intervention Orders, Family Court Orders, Community Corrections Orders etc.Charges, Warrants or an Undertaking of Bail.A mental health diagnosis and/or disability
RELEASE OF INFORMATION:
The client consents to sign an Authority to Release Information Form during the intake and assessment interview for the release of their: 1. Police, corrections, child protection and court records. 2. Medical history and medications record. 3. Details of previous relationship breakdowns with family and/or friends.
Referrer Details
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