Walk Tall
Walk Tall provides free counselling and emotional support for
children and young people, non-offending family members
and/or their carers
Who are we?
Walk Tall is funded by the Daniel Morcombe Foundation and is managed by Act for Kids. Walk
Tall provides counselling and emotional support to children and adolescents on the Sunshine
Coast who have either experienced or are at risk of physical, emotional and/or sexual harm.
We also specialise in working with victims of, and those impacted by crime.
Staff?
Registered Psychologist, Diane Booth, provides the Walk Tall Services on the Sunshine
Coast. She has more than 13 years of experience as a Psychologist and 25 plus years’
experience working with vulnerable families and related agencies in the community sector.
What do we do?
Walk Tall aims to help strengthen the wellbeing of children and young people who have
experienced abuse, neglect, trauma and/or loss as a result of a crime as well as those at risk
of physical, emotional and/or sexual harm.
In addition, the service will provide support to non-offending family members and caregivers
to assist them in developing the necessary skills to enhance the psychological well-being of
the child, or children in their family. As it is important to ensure our work is integrated into the
life or plans for the child(ren) and young people, we also aim to work closely with their personal
and professional network.
What is our referral pathway?
Referrals can be submitted by a community support agency or self-referral representing the
child, young person and or non-offending family/carer. Before completing the referral form we
recommend an initial telephone enquiry be made to Diane Booth (07 54 421517) to discuss
the referral and eligibility.
Completed referral forms can be emailed to walktall@actforkids.com.au or sent to Walk Tall,
C/o P.O. Box 565 Palmwoods QLD 4555.
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Walk Tall
Referral Form
_____________________________________________________________________________
Referrer Details
I give permission for Walk Tall to contact me to discuss this referral
Yes [ ] No [ ]
Name of Referring Organisation:
Contact Name:
Contact Number:
Contact Email:
Referral Criteria
The Child/Young Person:
(To be eligible for service must answer Yes to 1 or more of the Referral Criteria in section
1 and Yes to all Referral Criteria in section 2)
Section 1: Referral Criteria
Has the child/young person been a victim of a crime?
Has the child/young person been impacted by a crime? (i.e. a family
member/friend/significant other has been a victim of a crime)?
Is the child/young person at risk of physical, psychological or sexual
harm?
Yes
No
[ ]
[ ]
Yes
No
[ ]
[ ]
Yes
No
[ ]
[ ]
Yes
No
[ ]
[ ]
Yes
No
[ ]
[ ]
Yes
No
[ ]
[ ]
Yes
No
[ ]
[ ]
Section 2: Referral Criteria
Does the child/young person reside in a stable home environment and
does not require crisis intervention?
The child/young person Is not the subject of a current court proceeding.
The child/young person’s care giver/s or guardian is aware of the referral
to Walk Tall.
The child/young person’s care giver/s or guardian is willing to participate
in the therapy process.
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Walk Tall
Referral Form
_____________________________________________________________________________
Child/Young person being referred
First Name
D.O.B
Current Living Arrangements
How long has the child been living in this
current arrangement?
Ethnicity
Name of
Educational
Facility
Surname
Gender
Language
Spoken
Year
Contact Parent/Caregiver
Does the referrer have permission from the contact parent/caregiver
to release their contact details and provide the referral information?
Has the contact parent/care giver signed an ROI to enable the
Referrer to discuss information about the child and or family?
(Please attach copy)
First Name
Age
Relationship to
Child
Yes [ ] No [ ]
Yes [ ] No [ ]
Surname
Gender
Ethnicity
Language
Spoken
Contact Details:
Address
Home ph.
Mobile
Email
Please outline reasons for the referral at this time (attach additional information if
necessary):
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Walk Tall
Referral Form
_____________________________________________________________________________
Please outline presenting concerns in regards to the child/young person (i.e. abuse
and/or neglect concerns and/or behavioural, intellectual, emotional, relationship, physical
and mental health concerns)
Has the child demonstrated any unsafe behaviour towards self or others, past or
present? If yes, please provide brief details?
Please list any court orders in place pertaining to the child? (E.g. DVO, Parenting Orders,
Custody Order, Child Protection Order, Temporary Assessment Order;, Court Assessment
Order).
Please indicate which documents you have enclosed to help us think more about this
referral
Genogram
Current Case Plan
Court Reports/Orders
Discipline Specific
Assessment/Report
Other- Please list:
Chronology
Child Protection
History
Other issues or matters of concern
Please email referral form to walktall@actforkids.com.au
Thank you taking the time to complete our referral
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