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Parent or carer MHST referral form

There are 4 sections to complete on this form.  

In sections 1 to 3 we ask for information about consent and contact details. 

In section 4 you can tell us about the reason for making this referral.

This form may take around 15 to 20 minutes to complete.

1. Consent
If your young person is over the age of 13, their consent is required.

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