Social prescribing self-referral form for children and young people

Eligibility

To be eligible you must:

  • A young person aged between 11 (in Year 7 or above) and 18 years, if you are under 13 an adult must fill this form out on your behalf
  • Live in, be registered at a GP Practice, or attend school/college in Shropshire
  • Require additional support provided by social prescribing, in order to help and motivate you to take action to improve you health and wellbeing
  • Be able to communicate and engage with a Healthy Lives Advisor and the activities on offer.
  • Confirm that I am completing as the Young Person or Parent Carer (for referring Organisations please contact healthylives@shropshire.gov.uk)