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Children and Young People's Counselling Service
Referral Form 

Please note, we are not a crisis service, if you need immediate support you can contact:

Samaritans on 116 123 or Child Line on 0800 1111

North Yorkshire out of Hours Mental Health Helpline 0333 0000 309

Fields marked with* must be completed.

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Self Referral
Can we leave a voice mail and text message on your phone

Thanks for submitting!
 

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