Referral Form for Children & Young People.

#All information on this form will be treated as confidential and will be disposed of in line with our GDPR Policy. 

Please Note: The role of Edward’s Trust is to assist with the difficulties that arise as a result of bereavementOur organisation may not be suitable if the problems have existed for a long time and are not related to the bereavement. If referring more than one child, please use one form per child. It is important that this form is completed in full. 

New Field

11 + 4 =

Return completed form to: 

Edward’s Trust3 Vicarage Road, Edgbaston Birmingham B15 3ES 


Tel: 0121 454 1705