Self Referral Form

Our service is available age 13 to 25th birthday (last referral age 24th birthday) if you live, work or are being educated in St Albans and District. We are open 10am till 7pm Monday - Thursday, 10am till 5pm on Fridays (we are not currently open on weekends). Youth Talk offers one to one counselling and group therapy.
Please note that our service is self-referral only. As such, we will then call to get any further information and set up an initial consultation when one is available, this could be face-to-face or via Zoom. Please check for any missed calls, texts and emails. This form MUST be completed by the young person.

Personal Details

Permission to Contact

The main method of contact is email - please remember to check these

GP Details

Further Details

In order to provide our service we need to hold some details about you. Information about our data policy is available on our website and it is important you understand this. By submitting this form you are agreeing to Youth Talk holding your information and our data policy.