Youth Bridge The Gap Intake Form
What’s great about being a teen is that you are in one of the best stages of life. These are exciting times but we recognize also they can sometimes be challenging.
Now is the time to DISCOVER yourself, To explore who you are, Now is the time to uncover and deeply understand your uniqueness.
Find out how to express that uniqueness to the world in a grounded and balanced way
At Chakaura™,, we recognize the needs of the next generation as each generation is clearly different than the previous one, with its own special considerations. We also understand the role of parents and/or guardians in facing personal challenges while dealing with youth challenges. We support not only youths but the whole family unit, especially the parents since they are the leaders of the pack. When anyone within a family has a loved one being challenged by life experiences, all family members are affected so all should be involved in supporting a solution.
Here are some preliminary questions to consider so together we can explore and navigate the life challenges that present themselves for us to grow into being better people. We are here to support your Journey of Self-Discovery and these questions gives us a peek into your world which helps us better help you.
Many of our questions are about things that can affect your health and well-being. Some of the questions might not fit you. It is okay to leave some questions blank. Please answer these questions on your own, without help from an adult or friend, and be as honest as possible. Your answers are private and kept confidential.
We will only talk to your parent/guardian about this information if we have a serious concern about your health and safety.
BUT, before we talk to a parent/guardian, we will talk about it with you first.
PLEASE FIND A QUIET PLACE TO ANSWER THE QUESTIONS BELOW. THIS WILL TAKE A BIT OF TIME.
