Parent and carer consent

Parent and carer consent is required for any referral for P6 and P7 Primary School counselling or art therapy support.

Contact details

We need an email address to reply to you directly.

Please note that all fields or sections marked with a green asterisk * are required to submit this form.

Email*

Please ensure to include your official and valid email address.

Young person’s details

Please ensure that you provide all of the requested information.

Details

The details below are required for efficient lines of communication.

First name*

Second name*

Date of birth*

Address*

Postcode*

School*

Please note: this service is limited to Primary Schools in Fife.

Parent or carer’s details

Please ensure that you provide all of the requested information.

Details

We will need your details to proceed with this referral.

First name*

Second name*

Address*

Postcode*

Phone*

Email*

Relationship to young person*

Other referrer

If you are neither the young person’s parent or carer.

Details

Please ensure that all fields are completed.

First name*

Second name*

Your role*

Head teacher

Social worker

Other (please give details)

Consent

Do you give consent to proceed?

Yes, I give consent as a parent, carer, or other*

This is required to proceed with this referral.

Yes

General data protection regulation (GDPR)

To provide counselling or art therapy we need to be able hold some of your sensitive personal data.

Yes, I agree to DAPL holding sensitive data*

This is required to proceed with this referral.

Yes

Please read our GDPR privacy policy if you have any concerns about personal data privacy.

Before submitting your consent approval, please double-check that all required * fields are complete.

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If you need help urgently, here's a list of contacts who can help.

Parent and carer consent

Contact details

Leven

Kirkcaldy