Peer Mentor Support Service Referral Form

Eligibility Criteria

We will only accept referrals for low/mild mental health needs, and for those who meet the following cohorts

Is this young person aged 16.5-25? *

Yes No

Is this young person transitioning from Children’s Mental Health Services, to Adult Mental Health Services? *

Yes No

Has this young person accessed any NHS mental health services in the past 6 months other than for medication and/or crisis? *

Yes No

Is this young person leaving care? (N.B. we require PA involvement to commence support) *

Yes No

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