YMC Strong Minds (Young Londoners) Referral Form

As part of this project, we are aiming to address psychological and mental health issues through 1:1 counselling, create healthier family relationships through parental support, motivate young people through peer mentoring, and support practical rehabilitation.
Guidelines for completing this form:
Please only refer the young person/family if they meet the following criteria:
o The child/young person must be between the ages of 10 and 21.
o The child/young person SHOULD be either at risk of exclusion or
involvement in criminal activity, or have been involved in criminal activity.
o The child/young person must be living in Barking & Dagenham or Redbridge
o If under 16, please inform the young person and their parent/carer of the referral
before referring.

>I have read and understood the information given to me regarding the services You and Me Counselling will be providing me. I understand that if I have further enquiries, I can discuss them with the staff.
> I understand that while I / the young person named above is working with You and Me Counselling, I/they/we 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
> I can confirm the child's parent/guardian has been informed of the referral.
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