Child and Youth Questionnaire – Youth Submission

To be completed by Youth (12+ years)

This informa9on helps us in providing the best possible care for you and your family. Your answers will be kept strictly confidential as part of your clinical record.

If information given during this questionnaire suggests there may be harm to yourself or to others, including abuse or neglect, we are required by law to report the concerns to the appropriate authorities.

Please know that answering these questions is completely voluntary and will not affect the services you may receive from Island Community Services. We invite you, however,  to be as open as you can be to help us decide how best to support you.

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