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Please complete our form and we will get back to you shortly.

Please note that a record will be kept of your referral, stored on an encrypted online data system, adhering to all GDPR guidelines.

Your name (required)

Age - young person (required)

Your telephone number (required)

Your email address (required)

Address (required)

Eircode

Tell us a little about why you’re seeking support (required)

Which describes you best? (required)
I'm a young person under 18I’m a young person over 18I’m a parent, guardian or family member of a young person under 18I’m a parent, guardian or family member of a young person over 18I’m someone who works with young peopleI’m someone else

Where did you hear about Mindspace? (required)

Consent to Store Data (required) See below to learn how we use your information.
I am a young person over 18 and consent to Mindspace collecting, using and storing my dataI am a parent/guardian of a young person under 18 and consent to Mindspace collecting, using and storing their dataI am a young person under the age of 18*
* Please note that if you are under 18, after speaking with you, we will need to speak to a parent/guardian to obtain consent for you to attend Mindspace.

How we store and use your data:

Please note that your data will be recorded and securely stored on an encrypted online system, in full compliance with GDPR guidelines.
We use your information to contact you and to make sure we give you the best support we can.
We use your information to see how we did, and to make Mindspace better for everyone.
We are always trying to improve our service and mental health services for young people in general. We may sometimes use your information, and the information of others, to check how we’re doing, to share how we’re doing with everyone and to get ideas on how we can be a better support for other young people. Whenever we use your information like this, we make it anonymous so no one can tell it’s your information.
Limits to Confidentiality
There are rare occasions where we might have to share your information for your own safety. Mindspace is a free and confidential service, but there are some limits to confidentiality. If information is shared about a person being a risk to themselves or to another person, or of a child protection concern then this information will be shared with parents or guardians and/or the appropriate services, to help keep someone safe. In those situations, we are obliged by law to do so. We will always talk to you about these situations before you share anything with us.

Get Support

Please complete our form and we will get back to you shortly.

How we store and use your data:

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