[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-167230-105":53,"doc-detail-167230-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","appendix-c-referral-form-template","Appendix C - Referral form template","","Appendix C provides a referral form template for the Central Registration and Enrolment Scheme (CRES). It guides CRES providers and local support services on proactive engagement, collecting family and carer information, and obtaining consent to share contact details for kindergarten registration and, where applicable, enrolment. The template includes instructions for updating highlighted fields, using provider branding, distributing the form, handling interpreter needs, and returning the completed referral to the CRES provider contact email.",{"@graph":63,"@context":123},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/appendix-c-referral-form-template/167230/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/appendix-c-referral-form-template/167230.png","ImageObject",442,249,{"name":88,"@type":89},"Theodora","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/vnd.openxmlformats-officedocument.wordprocessingml.document","2026-10-02","2026-08-31",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",8,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115,119],{"name":106,"@type":107,"acceptedAnswer":108},"Who should use this referral form template?","Question",{"text":109,"@type":110},"CRES providers in Stage 1 (proactive engagement and awareness) and MCH, Child Protection, Child FIRST, Orange Door, LOOKOUT, and other child and family support services staff use it to obtain consent and support kindergarten registration.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What information is the referral form used to collect?",{"text":114,"@type":110},"It collects information from families and carers who may have difficulty completing kindergarten registration, including contact details for sharing with the CRES provider to initiate contact and provide support.",{"name":116,"@type":107,"acceptedAnswer":117},"How is consent handled when a written signature is not possible?",{"text":118,"@type":110},"If written consent cannot be obtained or it is impractical, the form provides a right column for verbal consent procedures.",{"name":120,"@type":107,"acceptedAnswer":121},"Can the referral form be used for multiple children from the same family?",{"text":122,"@type":110},"Yes. If the same family or carer is the legal guardian, the form can be used to refer multiple children by listing each child’s name in the relevant field.","https://schema.org",{"og:url":78,"og:type":125,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":127,"canonical":78},"index,follow",{"doc_id":129,"site_id":56},167230,1788210533,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":88,"user_avatar":134,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":47,"language":140,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":61,"update_tm":130,"read_time":73},687197207919,"https://ap-avatar.wpscdn.com/avatar/a000253d6f5f7c60be?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779446848396160552","Appendix C | Referral form template\nAbout this template\nNote: please remove these instruction pages when completing the template\nThis template should be used by CRES Providers in Stage 1: Proactive engagement and awareness. Refer to section 4.1 of the CRES Practice Guide for more information on this step of the CRES process.\nThis document is a part of a suite of CRES documents. Figure 1 below maps the relationship between the Development Guide, Self-Assessment Tool, Practice Guide and this document.\nFigure 1 | A map of CRES documents\nto complete this template:\nAll template content can be tailored, but content highlighted in yellow must be updated to be relevant to your CRES. Consider your location and context, whether your CRES charges fees and whether you have additional local priority criteria. For example, “[council name]” must be replaced with the name of your council for content to make sense.\nChange this form to CRES Provider branding\nHOW TO USE THIS FORM WHEN COMPLETED:\nRemove the first page of this document.\nDistribute to MCH staff and support service staff for use referring families and carers who need additional support.\nREFERRAL FORM\nCentral Registration and Enrolment Scheme (CRES)\n[CRES provider]\nDate:\nVersion:\n\u000f\nCentral Registration and enrolment SCHEME REFERRAL FORM\nWhat is this referral form?\nThis form should be used to collect the information from families and carers that you believe may find it difficult to complete kindergarten registration for their child.\nThis form is used by MCH, Child Protection, Child FIRST, Orange Door, LOOKOUT and other child and family support services staff to obtain consent from families and carers to have their contact information shared with [CRES Provider] for kindergarten registration and (where applicable) enrolment.\nThe contact information collected allows [CRES Provider] to initiate contact with the family or carer and provide support throughout the registration process.\nHow to use this form\nIf you assess that a family you are supporting will have difficulties completing the registration process alone, explain and complete this form with the family.\nInformation to assist in conversations about kindergarten, registration and enrolment, Priority of Access criteria and reduced cost kindergarten is available in the Information for CRES Partners pack you received from [CRES Provider] and on the DET website at \u0013 HYPERLINK \"https://www.education.vic.gov.au/parents/child-care-kindergarten/Pages/default.aspx\" \u0014www.education.vic.gov.au/parents/child-care-kindergarten/Pages/default.aspx\u0015.\nIf you assess that the family or carer may have difficulties completing registration alone:\nExplain that you and [CRES Provider] can help them to register\nExplain that any information collected is only for the purposes of supporting them to register their children for kindergarten, and the information will not be shared with any other organisation for any other purpose\nRequest that they sign this form to indicate they consent to you / your organisation sharing their details with [CRES Provider]\nNote any need for an interpreter on the form\nReturn the form to the [CRES Provider] at [CRES contact email address].\nIf they are unable to give written consent or if it is impractical for them to do so, you may use the right column for verbal consent procedures. If you require a translated copy of this form to assist in your conversation with the family or carer, please contact [CRES Provider].\nThe referral form can be used to refer multiple children if the same family or carer is their legal guardian. Simply include each name in the Child’s name field in the form below.\u000f\nReferral from local support services to the [CRES Provider]’s Central Registration and Enrolment Scheme\nThe information you are providing here will be sent to the [CRES Provider] so they can contact you to discuss enrolling your child in kindergarten. This information will not be shared with anyone else.\nFor the referrer: Please read out the ab","cbCaig8Aw0rkKFAb","https://ap.wps.com/l/cbCaig8Aw0rkKFAb","docx",200194,"English","# About this template\n## How to use this form when completed\n## Referral form\n## Referral from local support services","[{\"question\":\"Who should use this referral form template?\",\"answer\":\"CRES providers in Stage 1 (proactive engagement and awareness) and MCH, Child Protection, Child FIRST, Orange Door, LOOKOUT, and other child and family support services staff use it to obtain consent and support kindergarten registration.\"},{\"question\":\"What information is the referral form used to collect?\",\"answer\":\"It collects information from families and carers who may have difficulty completing kindergarten registration, including contact details for sharing with the CRES provider to initiate contact and provide support.\"},{\"question\":\"How is consent handled when a written signature is not possible?\",\"answer\":\"If written consent cannot be obtained or it is impractical, the form provides a right column for verbal consent procedures.\"},{\"question\":\"Can the referral form be used for multiple children from the same family?\",\"answer\":\"Yes. If the same family or carer is the legal guardian, the form can be used to refer multiple children by listing each child’s name in the relevant field.\"}]","Appendix C - Referral form template | DOCX"]