Family Konnect

Intake Forms

Forms for Family Court / Private Agreement clients and for GOV/NGO partners. We look froward to working with you.

Completing this form allows us to understand your family's needs and ensure we can provide a safe, supportive environment. All information is strictly confidential.

Your information is completely confidential

Takes approx. 10-12 mins.

Intake/Referral Form for Private and Family Law Court Requests

This form represents the first step in the intake process with Family Konnect. All negotiations, including those involving legal representatives, must be finalised prior to commencing this process. Completion of this form by both parties is required before Family Konnect can provide services. The form takes approximately 10–12 minutes to complete

Type Of Service/s You Require:

Referral Date:

Ideal Start Date

Next Court Date:

If not applicable type N/A

Number of Hours Required

Only applicable for supervised visits. Note: Minimum service hours Is 3 hrs

Reason for Service Request:

(e.g. court ordered supervised contact, parental separation, mental health challenges, family violence, substance misuse)

Next Steps

We’ll contact you within one business day to book a short phone intake assessment.
On that call, we’ll ask a few more questions about your child, your situation, and the days/times you’d like services to occur.
After the call, you’ll receive a Service Agreement for signature outlining roles and responsibilities for all parties, payment terms, our cancellation policy, and reasons services may be terminated.
Then we’ll allocate a supervisor and arrange the visits, keeping you updated at each step.