Young People’s Self Referral Form

On this page you will find the form to make a self referral into BDP’s Youth Team

Your Details

Are you in care or a care leaver?(Required)
Are you a young carer?(Required)

Primary Carer’s Contact Details:

If you are 13 or over we will not contact your parent/carer without you knowing. However, if you are under 13 a parent/carer needs to be aware of the referral.

Further Details:

Having problems completing the form or want a chat?

If you are having problems completing this form or would like to have a chat about your referral, please call 0117 987 6000 or email