SAFE Referral Form

Sexual Abuse Family Engagement

Our SAFE project aims to help young people and their families who have been affected by sexual abuse. We not only work alongside the victim offering therapeutic support but also support their family to achieve a complete and SAFE environment for the young person to deal with the trauma they have faced. We offer this service to those aged 5 - 18, extending to 18 - 25 for those who have learning difficulties.

Referral Information
Referrer Individual

If you are self referring please use your own name

Referrer Organisation
Young Person
Parent/Carer/Next of Kin
Details of access requirements
e.g. YOT/CYPS/AMH
School or College
GP Contact

Please leave GP details blank if unknown

Activity
Supporting Documents
Files must be less than 2 MB.
Allowed file types: txt rtf pdf doc docx odt.
Files must be less than 2 MB.
Allowed file types: txt rtf pdf doc docx odt.
Files must be less than 2 MB.
Allowed file types: txt rtf pdf doc docx odt.