If the young person named above is under 13 years of age, parents/carers need to be aware of the referral.
The following boxes need to be completed in full for the referral to be assessed:
We will assess the information provided and will contact the person named above as the referrer within two weeks from confirmation of receipt of this form to discuss the next steps.
I understand that by completing this form, the details I have provided above will be taken, saved and stored by Creative Youth Network for data protection reasons, namely, to provide one to one support to young people. I have been advised that if I want to know more details about how Creative Youth Network deals with my information, I can ask to see the full Privacy Notice for Young People, Parents and Carers May 2018.