Booking PACE - Access Therapies Fife NHS

Parent Support and Advice Service– Booking Form

Company

This field is for validation purposes and should be left unchanged.

Personal Details

Name(Required)

Title First name Surname

Date of Birth(Required)

Phone(Required)

Email(Required)

Enter Email Confirm Email

Child Details

Child's Name(Required)

First name Surname

Child's Date of Birth(Required)

Minimum age 4 and maximum age 17.

Address Details

Address(Required)

Street Address Address Line 2 City Postcode

Your GP Practice

Your GP Practice(Required)

Child's Details

Is your child 12 years or older?(Required)

Children and young people aged 12 years and over must agree to their parent or carer discussing their difficulties and needs with the Parent Support and Advice Service. We are unable to offer an appointment without their consent. Do you confirm that your child has given permission for you to discuss their difficulties and needs with the Parent Support and Advice Service.

We are unable to offer you an appointment without your child’s consent. Please discuss your concerns with your child’s school or GP to consider best next steps.

Are you concerned about your child self-harming or having suicidal thoughts or plans?

Yes

Please discuss these concerns with your GP or other professional you may be working with. If you are worried about the immediate safety of your child please contact A&E, 999, or NHS 24. Further information is provided under the Urgent Help section on this webpage. Return to homepage

Have you been referred to, or are you receiving support from, the Child and Adolescent Mental Health Service (CAMHS) or the Child and Family Primary Care Psychology Service (PCP)?

Please discuss your concerns with the professional you are working with.

Thank you for completing this form. Please select an appointment which will be offered in Dunfermline from the list below. If you require this to be changed to a video appointment, please select an appointment time and contact us on 01383 565427.

Please select a date(Required)

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