One page. Most referrers complete this in under five minutes.
Urgent concern?
This form is not for emergencies. If someone is at immediate risk, call 999 or the Samaritans on 116 123.
What happens next
✓ Acknowledged within 1 working day
✓ First appointment within 5 working days
✓ Attendance report to you within 48hrs
Prefer to send by email?
Download our referral pack and return it securely.
Pack coming soon — please call or email us instead.
Urgent concern?
This form is not for emergencies. If someone is at immediate risk, call 999 or the Samaritans on 116 123.
Confidentiality has limits.
As we work with criminal justice agencies, some information (risk of harm, safeguarding concerns, court-directed reports) may be shared.
Read more.
