Submit an Enquiry

NOTE:
* If you wish to report an incident of complaint, student misconduct or a concern to our Safer Community team, please click here.
* If you require an accessible form, please click on the 'three dots' at the top right corner of this form. This will enable the Accessibility Mode.

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Your details

Please provide your full name.
In some instances it may be necessary to contact you by phone.

It is important to include all information that you consider relevant to assist us with our processing of your referral. Without comprehensive information we may need to contact you for further information or clarification which may result in a delay in your access to services.

If necessary or applicable, please attach any relevant documentation.
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Confirmation

Privacy Collection NoticeRequired

La Trobe University respects the privacy of your information and is bound by various privacy legislation including the Privacy and Data Protection Act 2014 (Vic) and the Health Records Act 2001 (Vic).

 

La Trobe’s Health, Wellbeing and Inclusion division collects your information in order to provide you with our services and assistance.   When you see one of our team, we are required to maintain notes (e.g of sessions, treatment and/or intervention plans).   The teams within the Health Wellbeing and Inclusion division work collaboratively as a one service, to provide you with the best possible service and support.  What this means is that your personal information may be used by different parts of the Health, Wellbeing and Inclusion as part of providing you with our services.   We will, however, only disclose your personal information outside of the Health, Wellbeing and Inclusion division with your consent or as permitted by law.

 

You have a right not to disclose personal information to us.  However, if you do not your provide your personal information then we may not be able to assist you.

 

You also have the right to access the personal information we hold about you (subject to any applicable legal exemptions), by contacting us at wellbeing.checkin@latrobe.edu.au (Students) or staff.wellbeing@latrobe.edu.au (Staff)

 

Please read our full privacy statement. (Please note, this opens in a new window)

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