- Please put as much detail as you can in this form.
- Please ensure that the information provided in this form is a true reflection of the wishes, feelings, and support needs of your son/daughter.
- Wherever possible, your young person should refer themselves into our service using this form: click here.
If you need any help with this form, email: firstname.lastname@example.org
- We are not a crisis service.
- We are not a 24-hour service.
- We can’t give debt advice.
- We can’t give advice or recommendations for credit facilities or financial services.
- We can’t provide in-home support.
- Daisy Chain will need to hold your data in order to provide support.
- Completing this form is not a guarantee of support.
- Daisy Chain can only provide support if we feel we can meet your son/daughter’s needs.
- The information provided in this form must be true and an accurate reflection of your son/daughters wishes, feelings and support needs.
- Your son/daughter must be aware of and have given consent for you to submit this referral.
- Your son/daughter will be the client of Daisy Chain and we will liaise directly with them about their support, unless otherwise specified by the client, or in exceptional circumstances (e.g., safeguarding).