• 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: myhome@daisychainproject.co.uk

Important Information:

  • 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).

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