MHST Drop In Request Form Logo

  • Drop In Request Form

    The HFEH Mind's Youth Services Mental Health Support team offers a drop-in/signposting service for Young People, Parents & Teachers attending our affiliated schools. Please complete this form to request a Drop-in call with our team.

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    Helpful Links

     

    If our Mental Health Support Team does not work within your school, please see the alternitive services & resources below that you may find useful to contact: 

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  • Your Details

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  • Child/Young Person (CYP) Details

    If you are a parent/carer please insert your child's details of your child below
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  • Your Availability

    To best accommodate your Drop-In please let us know what day & time you are free for a call from our team.

  • Risk Assessment

    The following questions will help us to assess your current risk

  • Over the past week:

  • Risk Assessment

    The following questions will help us to assess the current risk of the child/young person

  • Further Information

  • Emergency Contact Details

    Please provide the details of someone we could contact in case of an emergency

  • Child/Young Person GP Details

  • Child/Young Person Demographic Details

  • DATA PROCESSING & SHARING CONSENT

     

    The MHST provides emotional wellbeing and mental health interventions and support in education settings for children and young people aged 5 – 19. To provide this service Hammersmith Fulham Ealing and Hounslow Mind will need to process data relating to the child/young person, and that of their parent/carer. (N.B: this person must have legal parental responsibility for the child/young person).
    In accordance with our retention policy, we will keep your data on our systems for a period of 6 years. After the 6-year retention period your data will be deleted from our database unless we have a lawful reason for continued retention.

    To provide a more joined up, effective service for you/the client, Hammersmith Fulham Ealing and Hounslow Mind may need to share your/the client’s information with other service providers. These include NHS England’s Mental Health Services Data Set. This is a national database, which collects data on all clients in England receiving emotional wellbeing and mental health services through NHS-funded interventions. Other service providers also include past, current, or new services that would benefit the client where the client requires a different service to that which is offered by Hammersmith Fulham Ealing and Hounslow Mind. We will only share your/the client’s data with consent unless we can lawfully do so without consent. Consent can be withdrawn at any time.

    If this section is not completed fully, the referral cannot be processed.

    Please ensure the boxes below are ticked to provide your data processing & sharing consent:

  • I,* received verbal consent from * on
    Pick a Date*

  • Clear
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