This form is for referrals from family, friends, and community members concerned for an older person who is, or may be experiencing, elder abuse. You will be responded to within two (2) working days.
For safety reasons, we call from a private or unknown number. If you are not able to answer, we will leave a message if you have indicated it is safe to do so.
If the person you are referring is in immediate danger, please contact 000.
If you are unable to provide a time that is safe to call you about this form, please do not complete it. Instead, call our Helpline on 1300 368 821 at a time that is convenient for you.
By completing this form, you consent or SRV to contacting you on your preferred contact method. You acknowledge that you may also be referred to COTA Wise for assistance and information. Your information will be collected and stored in accordance with our privacy policy.