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2025 2026 Time2Talk referral form

REFERRAL GUIDANCE

The Time2Talk project supports young people and their parents and carers to resolve conflict through mediation. Our support is impartial, non-judgemental and confidential (unless we believe someone is at risk of harm).
Our service can provide support with:
– Families arguing over a specific issue, or several issues.
– Communication problems.
– Relationship breakdowns between young people and their parents/carers.
If adults in a family are arguing about child arrangements, family mediation may be more suitable.

CRITERIA

Before completing this form, please check that your case meets our criteria:
The young person involved is between 11 and 18 years old.(Required)
The young person lives in East Sussex.(Required)
All those involved are willing to speak to us and have a one-to-one meeting with our mediators, as a starting point.(Required)
Mediation is voluntary. Please do not complete this form unless you have everyone’s consent to take part.

WHO IS COMPLETING THE FORM

Name(Required)
Are you in family or from an external support agency?(Required)
Eg mother, uncle, step-father

THE YOUNG PEOPLE INVOLVED

Please provide details of all the children and young people involved
Name(Required)
Has this person agreed to speak to our service?(Required)
So sorry! We can’t go ahead without the consent of all those involved. Please ask this person if we can contact them and resubmit the referral only if you have their agreement.
Gender
DD slash MM slash YYYY
Address(Required)
Preferred contact method (if over 16 years old)
Are there any other young people involved?(Required)

Second young person

Name(Required)
Has this person agreed to speak to our service?(Required)
So sorry! We can’t go ahead without the consent of all those involved. Please ask this person if we can contact them and resubmit the referral only if you have their agreement.
Gender
DD slash MM slash YYYY
Does this young person live at the same address?(Required)
Address
Preferred contact method (if over 16 years old)
Are there other young people involved?(Required)

Third young person

Name(Required)
Has this person agreed to speak to our service?(Required)
So sorry! We can’t go ahead without the consent of all those involved. Please ask this person if we can contact them and resubmit the referral only if you have their agreement.
Gender
DD slash MM slash YYYY
Does this young person live at the same address?(Required)
Address
Preferred contact method (if over 16 years old)

THE ADULTS INVOLVED

Please list the parents/carers/other adults who will be involved.
Name(Required)
Has this person agreed to speak to our service?(Required)
So sorry! We can’t go ahead without the consent of all those involved. Please ask this person if we can contact them and resubmit the referral only if you have their agreement.
Gender
Address
Preferred contact method
Is there another adult involved?(Required)

Adult 2

Name
Has this person agreed to speak to our service?(Required)
So sorry! We can’t go ahead without the consent of all those involved. Please ask this person if we can contact them and resubmit the referral only if you have their agreement.
Gender
Does this person live at the same address as Adult 1?(Required)
Address
Preferred contact method
Is there another adult involved?(Required)

Adult 3

Name
Has this person agreed to speak to our service?(Required)
So sorry! We can’t go ahead without the consent of all those involved. Please ask this person if we can contact them and resubmit the referral only if you have their agreement.
Gender
Does this person live at the same address as Adult 1?(Required)
Address
Preferred contact method

WHAT HAS BEEN HAPPENING?

Eg physical or mental health or additional needs.

OTHER INFORMATION

It is helpful to know when and where meetings can take place, so we can match up with suitable mediators. Please select dates and times which might be possible for initial mediation meetings. These are normally held out of school hours, some time between 3:30pm and 7pm. Offering more dates makes it more likely we will be able to match you with mediators.
What would be the family's preferred meeting venue(Required)
Most meetings take place in our offices or online.
DD slash MM slash YYYY
1st time
DD slash MM slash YYYY
2nd time
DD slash MM slash YYYY
3rd time
DD slash MM slash YYYY
4th time
Any more dates?
The more dates you can suggest the more likely we are to be able to match you with mediators. Are you able to suggest another date?

So sorry! I'm afraid we are unable to help you at this time.

We can only help young people aged between 11 and 18 who are living in East Sussex, and where all those involved in the case are willing to participate.

HASTINGS

Chichester Road
St Leonards-on-Sea
East Sussex
TN38 9BG

Tel: 01424 446808

HAILSHAM

Southview Western Road
Hailsham
East Sussex
BN27 3DN

Tel: 01323 442781

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