B.R.A.V.E Service: Referral Form

Building Resilience and Validating Emotions

The BRAVE Service is available to Medway Children and Young People (CYP) aged 5-18 years (or up to 25 for those with Special Educational Needs or Care Leavers). It offers therapeutic interventions in either one-to-one or group settings, with a minimum of 6 sessions and a maximum of 12 (depending on clinical needs). This service is designed for CYP experiencing low mood, anxiety, and related behaviours, such as self-harm.

We accept both self-referrals for this service as well as professional referrals.

B.R.A.V.E Service: Referral Form

CYP Personal details


(If applicable)
(If applicable)
(If deemed appropriate)
(If deemed appropriate)

Parent/ main care giver details


Referral Reason


Associated Risk


(i.e. self-harm, suicidal thoughts, suicidal intent etc.)
(i.e. abuse, neglect, exploitation, trafficking, bullying, domestic violence etc.)

Please complete the section below if this referral is being made by someone other than the individual themselves.

Referrer Details


If no, please do not submit referral until consent has been obtained from young person and/or parent/carer.