Parental/Guardian consent for children and young people to have counselling

What happens to my information?

Denbighshire County Council collects your personal information to provide you with services relevant to your request.

For further information about how we handle personal information, please view our privacy notice.

Before you begin
To complete this form, you will need to:
- provide the reference number given to you by a counsellor
- read the following:
Your first name
Your last name
Child's full name
What is your relationship to the child?
ParentCarer/GuardianOther
Your email address (it's helpful if you can provide us with an email address, as we may need to contact you)
Your phone number
Please provide your reference number:
Please let us know which school or college your child attends