CAMHS self-referral form

This CAMHS Gateway self-referral form is for 16-17 year olds in Dorset.

1
Your details
Parent/carer information
Please note: If we have concerns relating to risk and are unable to contact you, we will contact your parents/carer.
Demographic details
Background Information
Other help you've tried or been offered
So that we can know more about what other help you've tried/been offered, please tell us who else you've contacted, or what other services you've seen so far
I/my family have had some help from:
Child and Adolescent Mental Health (CAMHS)