Logo with the word 'Kairos' in blue, featuring a yellow curved line across the 'K', and a yellow graph-like icon above. Text below reads 'Family and Personal Support Services' in green.

Referral Form

Make a Referral

If you would like to refer yourself or someone else to our services, please complete the referral form below. Completing the form does not commit you to anything — you are free to change your mind at any stage.

If, for any reason, the service is not taken up, we will not retain any personal information. We handle all referrals with the utmost confidentiality, and no details are shared without consent unless there is an immediate risk to life or serious harm.

We're here to offer support when you're ready — at your pace, on your terms.