Wellington Community Counselling Referral Form

Notes and Referral Process Summary

1. This form is to be used for the provision of counselling for individuals or family (“clients”) referred by Schools, GP’s, the Children’s Centre, & The One Team, in Wellington.

2. This form should be completed with the prior knowledge & consent of the parent/carer (wherever possible) of the client.

3. On receipt of this form, our counsellor will make contact with the parent/carer of the client, and arrange an initial meeting with them in which a full assessment will be made.

4. Our counsellor will also contact the referrer to arrange the initial referral session in the designated school/centre.

Referral Form

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