Supported Playgroup Referral

Our Supported Playgroup is a FREE weekly program, that a Smalltalk trained practitioner facilitates through each school term.

Supported Playgroup has a focus on a range of evidence based topics that are based on the importance of everyday interactions that you have with your children. These include the way they talk, listen and play with their children, read together and how they engage them in interesting and stimulating activities.

Smalltalk in home support is also available for families to be referred in. For more information please speak with Sally our playgroup facilitator about eligibility criteria – 0407 047 305

Referrers Details

Referrer's Name

Referrer's Agency

Referrer's Phone Number

Referrer's email address

Date of Referral

Have you completed a visit to the home?

YesNo

Parent/ Caregiver's Details

Name *

Phone *

email

Address *

Does this parent Identify as

AboriginalTorres Strait IslanderNeither

Child/ Children's Details

Child's Name *

Child's Date of Birth *

Does this child identify as

AboriginalTorres Strait IslanderNeither

MCH Key age and stage visit up to date

YesNoUnknown

Eligibility Citeria for Enrolment in a Supported Playgroup

Please tick any applicable

In addition, the following families are also eligible:

families in which a family member identifies as Aboriginal and/or Torres Strait Islander; families who are looking after children in kinship care arrangements (out of home care); families referred from Child FIRST or Child Protection families referred from or receiving Enhanced Maternal and Child Health Services.

Target group for In-Home Support

The target group for In-Home Support is families who are eligible to attend Supported Playgroup (see above) and have at least one of the following characteristics:

Parent aged 25 years or lessParent/ Guardian has not completed high schoolSingle parent family Ten or less books in the home.

Additional Information

Is the family aware of the referral? *

YesNo

Does the family consent for Warrnambool City Council Supported Playgroup Facilitator to exchange information with the referrer regarding this referral? *

YesNo

Privacy Policy

I have read and agree with the Warrnambool City Council Privacy Policy *

Read the Warrnambool City Council privacy Policy here

This personal information is being collected by Warrnambool City Council. It will not be disclosed to any other external party without your consent, unless required or authorised by law. If the personal information is not collected we will not be able to contact you with more information about the program you have inquired about. If you wish to alter any of the personal information you have supplied to Warrnambool City Council, please contact Council via 5559 4747 or email pacs@warrnambool.vic.gov.au