Comment: Have you done all you can to encourage the young person to inform parents or guardians? Comment: Yes / No Have you determined that the young person’s best interests are served by offering advice or treatment without parental consent? Yes / No Comment: Are you satisfied that the young person is likely to begin or continue injecting without the use of our needle exchange service? Yes / No Comment: Are you satisfied that the young person’s physical or mental health is likely to suffer unless they receive advice or treatment? Yes / No Comment: Is it in the young person’ best interest to give needle exchange advice or service? Comment: Yes / No Is the young person living with parents or others? Comment: Yes / No Are there any specific concerns or issues (e.g. Mental health, self-harm, etc.)? Comment: Yes / No Worker name................................................ Signature.......................................................... Date...................... Client name.................................................. Signature.......................................................... Date......................
Comment: Have you done all you can to encourage the young person to inform parents or guardians? Comment: Yes / No Have you determined that the young person’s best interests are served by offering advice or treatment without parental consent? Comment: Yes / No Are you satisfied that the young person is likely to begin or continue injecting without the use of our needle exchange service? Comment: Yes / No Are you satisfied that the young person’s physical or mental health is likely to suffer unless they receive advice or treatment? Comment: Yes / No Is it in the young person’ best interest to give needle exchange advice or service? Comment: Yes / No Is the young person living with parents or others? Comment: Yes / No Are there any specific concerns or issues (e.g. Mental health, self-harm, etc.)? Comment: Yes / No Worker name................................................ Signature.......................................................... Date...................... Client name.................................................. Signature.......................................................... Date......................
Needle-Exchange-for-under-18s.docx