Parent / Guardian Acknowledgment

(Youth Text-Based Peer Support)

This form explains how youth text-based peer support works and what to expect.

What this service is

• This is peer support, not therapy or counseling

• Support is text-based and not provided in real time unless arranged

• This service is not for emergencies or crisis response

What peer support includes

• Listening and emotional support

• Encouragement of self-reflection and healthy coping

• Respect for youth voice and choice

Peer support does not include:

• Diagnosis or treatment

• Medical or mental health advice

• Crisis intervention or emergency services

Privacy & safety

• Conversations are treated with care and respect

• There are limits to confidentiality if there is concern about serious harm

• In safety situations, support may shift toward connecting with appropriate adults or emergency resources

Parent / Guardian role

• Youth participation is voluntary

• Youth may choose what they share

• Parents/guardians are not included in text conversations unless discussed in advance

This support is intended to complement — not replace — other supports in the youth’s life.

Acknowledgment

By continuing, I understand that:

• This is peer support, not therapy

• This service is text-based and not for emergencies

• Youth participation is voluntary

• I have had the opportunity to review how this support works