PARENTAL CONSENT FORM

All parents must complete the parental consent form for children/young person’s partaking in the service, before counselling can commence. 

YOUNG PERSON’S DETAILS:

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PARENT/GUARDIAN DETAILS:

I have read and understood the information given to me regarding the services You and Me
Counselling provides. I understand that if I have further enquiries, I can discuss them with the staff.
I understand that while the young person named above is working with You and Me Counselling,
he/she will be subject to the service’s code and conduct of behaviour and will be required to
conform with the instructions and guidance of the service.