Refer yourself for counselling (14-18)
Use this form if you want to refer yourself for the young people’s counselling service at Survivors’ Network.
This service is for young people of any gender affected by sexual abuse or sexual violence in any way between the ages of 14-18 (up to their 19th birthday).
- You can contact our Young People’s Counsellor with any questions on yptherapist@survivorsnetwork.org.uk
- If you prefer you can download the form as a Word document to fill out in your own time, you can post the form to us or drop it into our office – see our contact page for details. You can also email a completed form to yptherapist@survivorsnetwork.org.uk.
We have lots of resources designed to support you with a range of topics, including a comprehensive self-help guide.