Please complete the relevant form in confidence.

We will get back to you as soon as possible to discuss a planned approach under the guidance of Koru.

  • Referral Guidance:

  • Can a young person be referred to KORU for therapy if they are already receiving therapy from another source?

  • • No, because it becomes very confusing for the young person. It is only in rare circumstances that exceptions may be made.
  • • No, because it is also a waste of resources
  • Referrer, agency, address and telephone:

  • Professional body
  • Date Format: DD slash MM slash YYYY
  • Date Format: MM slash DD slash YYYY
  • School and Name of Key Worker

  • Name & details of funding source

    Who is funding this application. Who shall we be invoicing?
  • Please note funding is paid in full before the start of the therapy. No refunds can be reimbursed but sessions cancelled with more than 48 hours notice can be passed on for work with other children and young people.

  • Date Format: DD slash MM slash YYYY