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.

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

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?

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