Parent Peer Support Referral Form

We understand that being a parent can be difficult, and looking after a child with mental health difficulties can be challenging. It is important for parents/carers to get support and guidance for themselves. Bolton Together has a Parent Peer Support offer that aims to help support parents/carers of children experiencing poor mental health and wellbeing.

Through our Parent Peer Support parents/carers can have the opportunity to meet and connect with other parents/carers, access group support such as mindfulness and positive psychology, discuss how best to support their child, and have the opportunity to find out about other resources and support that may be beneficial to them.

For more information on what our parent Peer Support offers, please see the overview here.

Please fill out our Parent Peer Support referral form below if you are interested in accessing this support. Please include details of what support you are looking for and a brief overview of your current situation.

1. Details of Parent/Carer Requesting Support

Name *

Postcode *

Phone *

Email *

How would you prefer to be contacted? *

Phone
Email

What is your relationship to the child/young person experiencing difficulties with their mental health? *

How old is the child/young person? *

Does the child/young person have SEND? *

Please provide a brief description of your situation *

3. Contact Details of Referrer

You do not need to complete this if you are referring yourself.

Tick this box if you are self referring

Self Referral

Name of Referrer

First

Last

Referring Organisation

Phone

Consent

If you are referring on behalf of someone please tick this box to confirm that you have explained who you are referring to and that the individual has consented to be referred. We can only accept referrals where consent has been given.

Parent Peer Support Referral Form

1. Details of Parent/Carer Requesting Support

3. Contact Details of Referrer

Bolton Together

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