Redbridge e-forms Redbridge Behaviour and Inclusion youth worker mentoring referral form 1Introduction2Pupil details3Pupil details continued4Parent details5School details6Referral7Proposed mentoring arrangements8Proposed mentoring arrangements continued9Services involved10Interventions and strategies11Declaration What does the Youth Service Mentoring Team offer? Through a regular programme of one-to-one support, we can begin to identify and address a whole range of issues that can cause some students difficulties in reaching their potential. This can include, but is not restricted to, matters of identity, self-esteem and resilience, social anxiety, relationships and behaviour. We can also mentor young people around issues of personal safety, including sexual health, drugs and alcohol awareness and social media safety. As mentors, we ensure that we signpost, or where necessary, make referrals to specialised services and agencies. We are flexible in our approach to the young person, using a range of methods to enable them to get the most benefit from their sessions. Redbridge Mentoring Programme - Structure Pupil's detailsFirst name(Required) Last name(Required) Date of birth(Required) Day Month Year Year group(Required) Pupil's detailsAddressFind addressSelected address Gender(Required) Ethnicity Parent's detailsFirst name(Required) Last name(Required) Telephone number Email address School detailsCurrent school(Required) Referrer(Required) Position Email(Required) Phone ReferralMain reason(Required) Desired outcomes(Required)Background issues Proposed mentoring arrangementsStart date: Day Month Year Sessions per week:(Required) No. of weeks:(Required) Proposed mentoring arrangementsAdditional notes:Location:(Required) Services involvedPlease name all services involvedSupply contact details of both current and past Intervention/Agency Contact first name Contact last name Email Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Interventions and strategiesPlease give details of interventions/strategiesPlease explain the strategies or resources the school has used to address the problems to date and how successful these have been. Please attach SEN Provision Map/ Timetable and relevant school data. Intervention Start End Outcome Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. File Attachments Drop files here or Select files Accepted file types: docx, pdf, txt, png, jpg, Max. file size: 50 MB, Max. files: 5. DeclarationParental Consent(Required) Yes No Date consent given(Required) Day Month Year Is Pupil aware?(Required) Yes No Date discussed(Required) Day Month Year