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Referral Form

To understand more about our referral process please click on the button 'Referral process' below. If you are seeking a diagnostic assessment and would like to understand how this referral process develops please click on the button 'Diagnostic Referral Process' below.

 

 

 

 

Update for new referrals: We are accepting new referrals for adult and child diagnostic assessments only. We are also accepting new referrals for adult therapy.

 

We are closed to new referrals for adults and children for initial assessments and closed to referrals for child therapy.

If you would like to submit a referral to our services please complete and submit the form by clicking on the button 'New Referral' below this paragraph. 

When we make contact about your request we will send information about our service, consent forms, an initial survey and some online assessments to complete to give us more information. ​To save any delays please ensure you have completed and sent everything back via the secure links you are sent on text and email. We will be in touch as soon as we are able to do so. The reason we ask for information ahead of appointments is so that we can match you with the most appropriate clinician.

NB: If you are an adult completing this on a child's behalf please select "Someone else" and seeking support for a "child".

If you are in need of urgent support, please contact one of the following services:

  • Text "SHOUT" to 85258 - this will connect you to ShoutUK, a free and confidential 24/7 support service

  • Call 116 123 - this will connect you to Samaritans, a free 24/7 helpline

Please note - when entering your mobile phone number, on the form, please us the +44 format and omit the 0 at the start of your number (example: 07876 543 321 becomes +447876 543 321) . We request this as we use a messaging service to communicate appointment information to you.

 

Please check what you have entered and ensure your mobile number and email address are correct.

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