Please fill in this form with the young person that you are going to refer. We appreciate that sometimes you may not be able to fill in the whole form while the young person is with you but there are some essential things that both the young person, the referrer and potentially parents and carers need to know.
Please note- Parental or Guardian consent is not legally required for secondary aged young people.
- You will receive an automated receipt for this referral. We will only contact you if the referral is rejected. Young people will be added to the waiting list for their school.
- Progress on referrals can be sought by contacted the service coordinator.
- We will contact the young person directly via the mobile number or email provided on this form.
- The young person needs to take responsibility for attending the counselling sessions and communicating with their counsellor.
If they don't attend and don't contact the counsellor their case will be closed.
If the young person's mobile number changes, they leave school, move to another school or no longer want to access counselling please let us know.
Please remember this referral is for counselling. It is not an emergency or crisis service. If the young person is expressing a wish to die and says that they have a plan of what to do, you must ensure that they are seen urgently by CAMHS or attend the local Emergency Departmenthttps://girfec.fife.scot/__data/assets/pdf_file/0034/187792/Self-Harm-Guidance-Sept-2017.pdfHOW TO SAVE ONLINE FORMS
When you submit this form a copy of the form will be automatically sent back to you. To save this please click on the print icon that will appear on your screen.
Use the dropdown box as that contains the link to your printer and select SAVE AS PDF.
Once selected hit the save button, and save and name the document to where you would like to store it or alternatively save it to your desktop and it can be moved/transferred from there into the client file.
Please be aware that the information you provide here will be shared with the young person. Please select
one option from the three below. This will indicate what DAPL work stream the young person will be seen under.
Additional Guidance:
Summer Term 2024- Please do not refer those in 6th Year or other planned school leavers through this route. We will not manage to see them within this term and any referrals will be closed at the start of the summer holidays. Please direct anyone in this situation to the Digital Drop-in service.
