Staff Consultation – self referral form 2024/25

Referrals for this offer will close on Friday 27th June for the academic year. If you would like to receive support this term, please make sure that your referral is submitted before the deadline.


The Staff Consultation is provided by Anna Freud. It is an individual 45-minute appointment with an optional follow up appointment via phone or video call with a trained practitioner. This can be about your own wellbeing or the wellbeing of a young person you are supporting including difficulties such as mild to moderate anxiety, stress and/or low mood. 

We can only accept requests for support from people who are a staff member at one of SCESS’s partner schools or colleges.  


Please note, completion of this form does not guarantee that we will be able to offer you a consultation. 


One of our team will contact you shortly with more detail. 


We hold all information confidentially, including information relating to equity & diversity, such as ethnicity & gender. As part of our service evaluation, we may use some information to monitor and identify where we need to focus efforts to ensure we are reaching a representative audience. For information on how we will use your data please refer to our privacy notice: https://brandplatform.annafreud.org/share/CbZgzaj3f2eTtfqZT2Xu




Please complete even if it is the same as your first name.




Please provide the reason for the consultation and nature of the concerns.



Please give full postal address of where you live now. Do not include postcode.



Please give the full name of your school/college. Not giving the full name will slow down the processing of your referral. If your school/college is part of an academy trust, please give the name of your specific school/college and not the name of the trust.

We offer video calls or telephone calls. Please state your preference, but we recommend a video call wherever possible.

Please note, our opening hours are 09.00 and 18.00 Monday - Thursday and Friday 09.00 - 12.00. If we are able to proceed with supporting you we will attempt to book an appointment with you to avoid these times but we can not guarantee this.

Please note our opening hours are 09.00 and 18.00 Monday - Thursday and Friday 09.00 - 12.00. We are unable to book consultation times outside these hours.

Examples of accessibility requirements include visual or hearing difficulties. Please give details of what adjustments might be needed.