Update your contact preferences You must be 16 years of age or older to complete this form. Step 1 of 3 33% About youYour name(Required) First Last Your email(Required) Your date of birth(Required) Day Month Year Which service you attendWe ask this question so we can send your request to the correct departmentWhich service do you attend?(Required)Adolescent and young adult serviceAutism assessment serviceCamden adolescent intensive support service (CAISS)Camden CAMHS children looked after and unaccompanied asylum seekersCamden CAMHS early intervention service for psychosisCamden CAMHS wellbeing teamCamden MOSAICCity and Hackney primary care psychotherapy consultation service (PCPCS)Couples unitCreative art therapyEating difficulties and avoidant restrictive food intake disorders (ARFID)Family drug and alcohol court (FDAC)Family mental healthFirst stepFitzjohn’s unitForensic CAMHS (FCAMHS)Fostering, adoption and kinship careGender identity clinic (GIC)Gloucester HouseGloucester House outreachHertfordshire outreach serviceMental health support teams (MHST) in schoolsNorth and South Camden community CAMHSParent consultation servicePortman clinicPsychological therapies for autism and learning disabilitiesPsychotherapyTrauma serviceWhole family serviceWhole family service (perinatal)Young people’s consultation service (YPCS) Secure emailTell us if you would like to receive secure emails from us. Find out more about what this is.Are you happy to receive secure email(Required) Yes No