Targeted Youth Support Service self referral

If you are a child or young person aged 11-18 you can request support from the Targeted Youth Support Service

TYSS support extends to anyone aged up to 25 with an EHCP or has been part of Children We Care For. You can refer yourself using the form below.

Your name

Please fill in your full name. If you use more than one name, include them all.

Your date of birth

We need to know your date of birth so we know you are the right age for the service and to check your identity.

Your address

We need to know your address so we can get in touch with you. It also helps us know what support is local to you.

Your school or college

You can also use this field to say if you are home schooled, in work or not in employment, education or training (NEET), or doing something else.

Your phone number

Please double check your phone number. It's OK to give us more than one number, if this helps.

Your email address

Please include the best email address to contact you on. It's OK to add more than one email address if that works.

How would you like us to contact you?

Phone

Email

Tick as many as you want

I need help with something else or want to say more

If none of these options look quite right, or you need to give us more information, you can write it here.

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