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Do you need help? We are here for you T: 07758763908 E: info@mums-aid.org Referral Form
MumsAid
  • Information and Support
    • Counselling
      • New mums
      • Working parents
      • Couples
    • YoungMumsAid
    • Group therapy
    • Befriending support
    • About maternal mental health
    • Useful links
    • Clinical supervision and training
  • About us
    • Our story
    • Why our work is vital
    • Our team
      • Our Ambassador
      • Meet our staff
      • Meet our Trustees
    • Our partners
    • Our impact
    • Case studies
  • Get involved
    • Volunteer
    • Supporting MumsAid
  • News
  • Contact us
  • Donate

Young mums referral form

Step 1 of 6

16%

CONFIDENTIAL

YoungMumsAid provides up to 24 sessions (6 months) of weekly counselling sessions to young mothers. The service will operate from the Brookhill and Mulgrave Children’s Centres on Thursday afternoons.

Eligibility: Young women who are…

  • Aged 16-21 years.
  • Pregnant or have a baby under 2 years.
  • Live in the Royal Borough of Greenwich.
  • Voluntary participants and not mandated to attend counselling.
  • Not attending any other counselling

As capacity is limited, we want to provide the service to those young women who are most likely to benefit. Before completing this referral form, please carefully consider...

  • Does the young mother want counselling?
  • Does she understand what counselling is?
  • Will she be able to commit to attending weekly for a period of up to 6 months?
  • Will she be able to benefit i.e. motivation, cognitive and emotional capacity to change?

We ask referrers to be prepared to support the young woman’s transition into the service.

If you wish to discuss a possible referral with a member of the YoungMumsAid team,

Please text or leave a voicemail message on 07899 661 081 and we will call you back.

Create a new referrer

Referrer's contact address
Name of Mother(Required)
Mother’s DOB(Required)
Mothers Ethnicity(Required)

Family’s home address
Preferred means of contact
Babies DOB/EDD
Do you have any other children?
GP Practice Address(Required)
HV Clinic Address(Required)
Children’s Centre preference
Crèche required during counselling?
Child protection plan or ‘Child-in-Need’ plan in place? (if so, what are the implications?)
Have you referred this mum to any other services?
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Contact us
E: info@mums-aid.org
T: 07758763908
Young MumsAid
E: young@mums-aid.org
T: 07758763908
london
MumsAid Maternal Mental Health Support Registered Charity, CIO 1179849
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