The Philippi Trust operates within Strict Safegaurding Policies and Proceedures.

What is Safegaurding?

A safeguarding or child protection policy is a statement that makes it clear what an organisation or group will do to keep children safe. It should include: a statement setting out the organisation's commitment to protecting all children. what the organisation will do to keep children safe and respond to concerns.

How Much Does the Service Cost?

Please be aware that the Philippi Trust is a Charity and receives no funding from any agencies. To access the Children's Services we request a minimum donation of £25.00 per session to cover our operating costs. There will be an initial payment on when the assessment placed and then payments will be a week in advance of appointment.

If you have the ability to Gift Aid the trust will also benifit from this recieving an additional 25% of your total donations.

'Donating through Gift Aid means charities and community amateur sports clubs (CASCs) can claim an extra 25p for every £1 you give. It will not cost you any extra.'

www.gov.uk

Philippi Kids Referal Form

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Philippi Kids Referral Form

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Childs Name: *

Date of Birth: *

Address including Postcode: *

E-mail address: *

Name of Parent or Gauardian: *

Tel No: Mobile & Home *

Relationship to the Child: *

Address if Different to Child:

Doctors Name and Address *

Childs School and Pastoral Managers Name & Contact *

Can we send a letter to your current address?

Can we telephone your home number and leave a message?

Can we telephone your mobile number and leave a message?

Can we send you an e mail?

I understand that the Philippi Trust is regulated and operates Safegaurding Proceedures and Policies

Has the Child been Adopted or in Care

Please give your main reason for wanting your child to receive Therapy: *

Has your child received any previous counselling/therapy? *

Are you involved with other agencies? If so, please give name of agency: *

Has your child any history of mental health issues – past/present? If so, please give details including any current medication: *

Any other relevant information including who lives in your house and their relationship to the child: (both parents, single parent, carer, foster carer, siblings, grandparents etc.) *

How were you made aware of Philippi Trust Kids? *

*

I herby agree that my data entered in the contact form will be stored electronically, and will be processed and used for the purpose of establishing contact. I am aware that I can revoke my consent at any time.

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