About this form
This form should be completed by a parent, carer or secondary school.
Vision runs a counselling service for 11-18s in Rossendale who are in crisis and need urgent, professional support.
Each 1-hour session costs £30, which can be paid by the parent/carer, school, or local authority. Appointments usually take place in person at our youth centre, but we can also run phone/Zoom sessions or visit the young person at school.
This referral form helps our team assess the needs of each young person and determine what level of support we can offer.