Self Referral Form

We are not a crisis or emergency service. If you need urgent help call 111 or 999.
If you need to speak to someone about your mental health you could contact:
- Your GP
- Childline – www.childline.org.uk (phone: 0800 1111 or text ‘shout’ to 85258)
- Samaritans – www.samaritans.org (phone: 116123)

Need help?

If you're aged between 13 and 18, and you're feeling down, worried, confused, or you're having trouble with friendships or at home, you can request support directly from the Mental Health Support Team (MHST). Just fill out the form on this page and we'll get in touch about ways we can help.
If you're under 13 we'll need permission from your parent or carer before we can support you. You can ask them to fill out our online form at www.brighterfuturesforchildren.org/MHST
MHST can support you if you attend one of the following schools: Alfred Sutton, Battle, Blessed Hugh Faringdon, Cranbury College, Christ the King, Churchend, Coley, English Martyrs, Geoffrey Field Infants, Geoffrey Field Junior, Green Park Village, Hamilton, Holy Brook, John Madejski Academy, Katesgrove, Maiden Erlegh Reading, Manor, Meadow Park, Moorlands, New Christ Church, Oxford Road, Palmer Academy, Park Lane, Prospect, Ranikhet, Reading Girls’, Redlands, Ridgeway, St Mary and All Saints, St Michaels, Southcote, The Wren, UTC, Whitley Park, Wilson.

Agreement

Your Details

To see how we use and store your personal information in line with GDPR please read our BFFC privacy notice (https://brighterfuturesforchildren.org/privacy-policy/ )

Next of Kin Information

We require parent/carer information in case we need to contact them regarding any serious concerns for your wellbeing.