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Manchester Mind Counselling Referral Form

Referrer

Your Contact Details

Your contact details will be held on Manchester Mind's database, which can only be accessed by current Manchester Mind staff.. We will not share these with any other organisation. We will use these details if there is an issue with the referral (e.g. we cannot make contact with the young person, or we need further details about their situation), a member of Manchester Mind staff may contact you for more information. For more details of how we hold personal data please see our Data Privacy Notice.

How did you hear about us?
Referring Organisation
Is the person you are referring aware that a referral is being made on their behalf, and that their details are being shared with Manchester Mind's Counselling Service?

We will use the details in this form to contact the young person and arrange an assessment meeting with them. Please make sure they are aware this will happen before proceeding with this referral.

Please make sure the Young Person is aware Manchester Mind will be in contact with then before continuing with this referral.

Person Being Referred
Preferred Communication Method(s)
Any information about how and when this young person prefers to be contacted. The best timeand method to contact them. Is it ok to leave a voice message or send an SMS.
Counselling Service Details

Counselling Service (18+)
Manchester Mind offers counselling as a paid for service. We can provide counselling to adults (age 18 and over) who are Greater Manchester Residents.

After receiving a referral, the counselling team will be in contact with person being referred in 5 to 10 working days to arrange an initial assessment meeting, where one of the team will talk to the person to see if we are the right service for their needs.

Following a successful assessment we offer  between 6 and 20 one-to-one sessions with a counsellor.

The initial assessment meeting is free. All subsequent sessions cost £36 each (£30 + VAT).

Counselling payments can be made online in advance of each session (or cash can be given on the day). 

Is the person that you are referring aware that there will be a charge of £36 per counselling session?
Referral Details
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