Cogent Urgent Escalation Service

This is for Urgent Mental Health Escalations Requiring Review within 1 hr.
This service is available Monday to Friday, 9am-5pm.

Client date of birth(Required)

Client email address(Required)

Client phone number(Required)

Reason for referral to Access Psych(Required)

Condition or diagnosis disclosed

Comments

If yes, indicate risk:

Comments

If a client is at imminent risk of harm to themself or others, please contact emergency services.

Name of Cogent consultant(Required)

Email address of Cogent consultant(Required)

Phone number of Cogent consultant(Required)

By submitting this online form, I confirm that: