For Professionals

Contacting us Directly

If you wish to discuss a young person or referral with CHAT, please telephone 01832 274422 or email info@chatyouthcounselling.org.uk. Please provide your name; your email or contact details; a brief description of the age of the person who needs help and their basic needs. We will follow this up with a discussion and meeting with an initial assessment as required.

Referral document to CHAT Youth Counselling

Email: info@chatyouthcounselling.org.uk

CHAT REFERRAL FORM

If you wish to refer a young person to CHAT, please complete the referral form below. Please enter as much information as possible to help our process, all boxes must be completed for the referral to be submitted successfully, thank you.

After successful completion you will see this message – ‘Thank you. Your referral has now been submitted to CHAT. You will be contacted in due course.’

Please note that the information you give on the referral form will be shared with the young person.

Make sure you fill in all required fields marked with a *

Referral Form Submission

Parent/Referrer Name *

Referrer Contact for Emergency *

Client Name *

Date of Birth *

Gender *

Ethnicity *

School / Workplace *

Home Email

Home Address *

Home Contact Number *

Mobile Number *

GP Name *

Surgery *

NHS Number (not compulsory)

Any illnesses or allergies

Reason for referral *

12 + 3 =

Using the RMC

The Referral Management Centre (RMC) provides a single point of access for professionals to make referrals to specialist community health services for children and young people. The RMC aims to facilitate all referrals to ensure that children and young people are seen by the right person, with the right skills, at the right time.

Click the button below to access this service.

Referral Management Centre