Stable Minds CYP: Counselling Waiting List

To add your child to our counselling waiting list, please complete the form below.

Once you've submitted the form, we'll be in touch within 14 days.

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Email *
GDPR-  We will only use the data you have submitted to create a referral and contact you you in response to this form in accordance with our Privacy. Policy. https://stablemindscyp.co.uk/privacy-policy-2/ *
Required
Young Persons Name *
First and last name
Parent/ Guardian of Young Person *
First and last name
Young persons date of Birth *
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/
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Young persons address- *Including Postcode* *
Phone number *
Please select you preferred method of contact *
Required
What school or college does the young person attend? *
What G.P surgery is the young person registered with? *
Please select the type of counselling option that feels right for your child/young person:   *
  • Milly – Senior Specialist Counsellor (£100 per session)
    Works with children and young people aged 3 and above. Highly experienced in child and adolescent counselling.

  • Patrick – Senior Specialist Counsellor (£100 per session)
    Works with young people aged 16 and above. Highly experienced in adolescent and adult counselling.

  • Lead Counsellor (£60 per session)
    Senior practitioners with extensive post-qualification experience age 3 and above.

  • Placement Counsellor (£20 per session)
    Counsellors in final training, under supervision. Ages 16+.

  • Fully Funded (Free)
    For families in receipt of benefits evidencing unemployment. Current wait approx. 12 weeks.

  • Required
    Is the young person currently involved with any other support services, such as CAMHS or Talking Therapies?   *
    Has your young person accessed crisis services (e.g., A&E, crisis lines) within the last three months?   *
    Required
    Is your young person currently on a waiting list for a CAMHS or private assessment?   *
    Do you consent to marketing emails to keep you informed about Stable Minds CYP news, workshops and funding - we will never share your details with any 3rd party and you can unsubscribe at any time *
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