Parents/carers and professionals: multi agency Emotional Health Triage referral form

The Emotional Health Triage helps families and profesionals navigate a range of early help services available and will recommend or signpost you to the most appropriate services to meet the needs of the child or young person being referred. Please note that we do not offer urgent support. If the child or young person is in crisis and needs urgent help please contact Child & Adolescent Mental Health Services (CAMHS) on 0300 365 1234, Children’s Services on 01635 503090, or the CAMHS crisis line on 0800 129 9999.

To enable us to process your referral without delay, please complete this form fully in as much detail as possible. If you have any questions before or during completion of this form please contact us on emotional.health.triage@westberks.gov.uk or on 01635 519018. You will not be able to save this form and progress later. Please ensure you have as much information as possible ready before starting, this includes but is not limited to:

• - Full name
• - Date of Birth
• - Home address
• - Ethnicity
• - Name of school if applicable
• - Description of emotional health difficulties they are facing (symptoms, triggers, duration, impact etc)
• - Contact details for parents/carers (phone & e-mail)
• - Knowledge of current or previous engagement with other support services such as CAMHS, Childrens Services, therapists etc.

The Emotional Health Triage service is open to children and young people under the age of 18, who have either a home, school or GP surgery address within West Berkshire. Please check your address eligibility using this link www.gov.uk/find-local-council