*Please note, if you are referring from an agency, you are responsible for  the safeguarding needs of your client*

If you are over 19 years of age, please refer into our adult counselling service 

Details of the young person:

Is the young person aged between 13-19?

To help us meet the aims and commitments set out in our equality policy, including not discriminating under the Equality Act 2010, we need to build an accurate picture of who we support in order to encourage equality and diversity. The anonymised data is also required by our funders, and improves our ability to apply for funding. 

We need your help to enable us to do this, and we’d be grateful if you could complete the following questions:  

Please read our Privacy Policy to understand how we use your data