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Manchester Mind CYP Services Self- Referral Form

Your Data and GDPR
Manchester Mind is registered with the Information Commissioner’s Office (ICO), and complies with the requirements and procedures of the General Data Protection Regulation (GDPR).

The personal details you give on this form will be stored in our password protected database, that only current Manchester Mind staff can access.

Under GDPR we hold and use this data on the basis of Legitimate Interest. To enable us to deliver the service(s) you have requested

We do not, and never will, sell your data for marketing purposes. We will only use it in the manner described below.

  • Your details will be used to contact you and discuss how we can help you
  • We will also use this data internally to monitor the effectiveness and fairness of our services
  • Some of the data you provide may be shared in an anonymised form, with our funding bodies

All information provided will be held securely by Manchester Mind in accordance with our Data Policy. For more information see our Data Privacy Notice.

Your Contact Details

Please leave either a phone number or email address, so that we can contact you about your enquiry.

How do you prefer to be contacted
Are you happy for voicemail messages to be left? Should we leave a message if someone else answers the phone? Is there anyone we should not speak to? Please give as much detail as possible.
CYP Services- Eligibility

Manchester Mind Children and Young People's Services
Counselling Service Open to young people aged between 15 and 25 who live in Manchester.
Peer Support Groups Open to young people aged between 18 and 25 who live in Manchester.

After you complete this form one of our experienced staff team will review your referral and contact you to offer the support that best suits your needs. If you have a strong preference for counselling or group support please let us know in the "How can we help you" section below.

If the you don't live in Manchester, or are under 15, you can still complete this referral form or you can call 0161 769 5732.  We will try to signpost you to services that are able to help.

Are you (your family) Manchester residents? Do you pay council tax to Manchester City Council?

Not sure of your local council? Find out using this postcode search.

Enquiry Details
What is your current situation? What issues would you like help with?

Most of our services are conducted in English.  We are able to offer some of our services in Hindi, Urdu, and Punjabi.  For other languages we use the help of an interpreter where we can.  Please let us know if you would like to explore this option.

Interpreter needed?
Are you getting help or support from other organisations?
How did you hear about us?
Have you used Manchester Mind Services before?
How did you hear about us?
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