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Wesley General Enquiry
Wesley General Enquiry
General
Enquiry Information
How may I help you?
Who is needing support?
Self
Individual
Family
Would you like to link into one of the Wesley Mission church services?
No
Yes
Would you like pastoral care support or someone to pray with you?
No
Yes
Would you like someone to give you a friendly phone call?
No
Yes
Are you in need of a crisis care package?
No
Yes
Current need
Currently have no food or money
Some food but not enough to last 2 weeks
Enough food for the next 2 weeks but unsure after that
Do you need help with a referral eg. Legal, Financial, Counselling?
No
Yes
Does your financial issue involve gambling?
No
Yes
Is there any pending legal action?
No
Yes
Are there any other details about your situation that you would like us to know about?
Received Via
Email
Telephone
In Person
Portal
How did you find out our service?
AFCA
Another gambler
ASFA
ATO
Bank / Creditors
Brochures
Centrelink/ DHS
Community services agency
Correctional system
CoS Program
Credit and debt hotline
Department of housing
Educational agency
Employment/ job placement agency
Family
Friends
Gambling Help
Gambling Venue
General Medical Practitioner
Health Agency
Humanitarian Settlement Program
Internal
LAC referral
Legal agency
Linkages Program
Media
Medical
My Aged Care Getway
NDIS referral
Not stated/inadequately described
Other agency
Other party
Phone book / Directory
Religious organisation / group
Self
Self help group
Telecommunication provider
TIO
Utilities providers
Service being inquired
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Contact Information
Contact
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First Name
Last Name
Street
Postal Code
Suburb
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State
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Email Address
Contact Number Type
Home Phone
Mobile Phone
Work Phone
Contact Number
Enquiry Header
Enquiry ID
Enquiry Received By
Enquiry Submitted By
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Date of Enquiry
Eligibility Answers
Is Wesley Connect
Is Wesley Connect
No
Is Wesley Connect
Yes
UID
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