Are you homeless or at risk of homelessness in the Perth metropolitan or regional WA area?

If you are living on the streets or in your car, couch surfing, facing eviction from your accommodation or escaping family and domestic violence, we may be able to help you.

Get in touch

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Online Enquiry Form

For a prompt online assessment please enter your information below. Please note that this form is only monitored during our open hours, if you require urgent assistance please call one of our emergency contacts.

This form is only for people who require a direct service from Entrypoint Perth. If you are a service provider, please click here.

Where are you currently located?*
- Perth
- Regional WA
- Other
Please state city/town where you currently are*
Please provide the following information
Your full name*
Gender
- Male
- Female
Date of birth
Do you have a partner accompanying you?
- Yes
- No
If yes, please provide name
Your partners date of birth
Do you have children in your care?
- Yes
- No
If yes please provide the full names and ages of the children in your care*
Is there anybody else with you?
- Yes
- No
If yes please provide the full names and ages of the people with you*
Contact phone numbers/details*
Can we call you on these numbers?
- Yes
- No
Is there are best day and time to call you during the hours our service is open?
- Yes
- No
Date*
Time*

: Hours

Minutes

AM/PM
Email address
Enter Email Confirm Email
What is your current accommodation situation?
- Staying with family or friends
- Facing eviction
- Hospital
- Sleeping rough in a public place
- Crisis / Emergency Accommodation
Are you currently homeless?
- Yes
- No
Where did you sleep last night? Please state location*
Can you sleep there again tonight?*
- Yes
- No
- Unsure
How long can you keep staying in this location?*
Are you at risk of homelessness?
- Yes
- No
If yes, what is the risk?*
Are there any current legal issues affecting you or your family/tenancy? (e.g. Violence Restraining Orders, tenancy breaches, custody disputes, facing legal charges, on parole, etc)
- Yes
- No
If yes, please identify*
Are you currently receiving any support from other agencies?
- Yes
- No
If yes, what agencies?
If yes, please state where you have come from?
Have you or anyone with you recently been tested for COVID-19 and/or waiting for results?
- Yes
- No
If yes, when?*
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Have you been in close contact with someone who has travelled overseas within the last 4 weeks?
- Yes
- No
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Have you travelled anywhere else in Australia in the last 4 weeks?
- Yes
- No
This field is hidden when viewing the form
If yes – select state?
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Are you feeling unwell and/or experiencing symptoms such as fever, dry cough, sore throat, high fever?
- Yes
- No
This field is hidden when viewing the form
If yes, when?
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What was the outcome?
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Have you had contact with someone who has tested positive with COVID-19?
- Yes
- No
Please add any further comments
By submitting this form I give consent for Entrypoint Perth staff to contact me on the above contact details*
- I Agree
Name
This field is for validation purposes and should be left unchanged.

Contact Us

Phone 1800 124 684 or 6496 0001

Monday – Friday 9:00am – 7:00pm

Saturday: 9:00am – 5:00pm

Sunday: 9:00am – 5:00pm

Please note Entrypoint is closed on December 25 and December 26, and January 1.

Please use the online enquiry form to contact us outside our operating hours.

Online Enquiry Form

Phone 1800 124 684 or 6496 0001

Are you homeless or at risk of homelessness in the Perth metropolitan or regional WA area?

If you are living on the streets or in your car, couch surfing, facing eviction from your accommodation or escaping family and domestic violence, we may be able to help you.

Online Enquiry Form

Please provide the following information

Contact Us

Phone 1800 124 684 or 6496 0001 • Website built by Bang Digital