Here at No Limits, we have a wide range of services to support children and young people with anything they may be facing.

Please complete the form below to tell us about the young person you’re referring to us and what they need support with. We’ll use the contact information you give us to contact you if that is what you indicate in the form.

Please note that we will make 3 attempts to get in touch with you or the young person after receiving this form, if we cannot make contact, we will have to close the referral.

We cannot accept referrals for counselling services with this form. Instead, please call 023 8022 4224 option 3,to speak to a member of the Counselling Admin team or to book a Counselling Assessment (slots are released 12.00 on a Monday and 18.00 on a Wednesday but you can contact at any time to book).

In common with all organisations that deal with personal information belonging to members of the public, we are obliged to check that you consent for us to hold your information for a limited period of time. We will store your information securely and redact it after a year.

  • Refer a young person

Refer a young person

I confirm that I am happy for you to hold my information. To find out how we use your data, click here.

Is your enquiry about counselling?

We are unable to proceed with counselling referrals via this form. Please call 02380 224 224 option 3 to speak to a member of the counselling admin team. If you need to refer to any additional services, please proceed with submitting this form, and contact the counselling admin team via the phone number above

Your name

Your email address

Your phone number (please add 'n/a' if no phone)

Your relationship to the young person

Please specify

Which agency are you from?

Who would you like us to contact about this referral?

Please tell us anything else we need to know about getting in touch:

Young person’s name

Young person’s email address

Young person’s phone number (please add 'n/a' if no phone)

Young person’s date of birth (this can be approximate if unknown)

Young person’s postcode and/or town/city

Young person’s gender

Young person’s ethnicity

Please tick what the young person needs support with:

If you know the service(s) you would like to refer the young person into, please specify below.

Please tell us anything else you think we might need to know:

We cannot accept a referral without you giving us your consent for us to hold your information for a limited period of time. Please go back if you want to change your mind.

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