Thank you for completing this referral form, we are looking forward to working with you!
What you share with us on this referral form will remain confidential and will help us to ensure that our communications and provision are tailored to your needs as much as possible. Our privacy notice contains full details of our data processing procedures and your rights in relation to data we hold about you.
If you have any accessibility requirements to complete this form online, or need support to make this referral, then please get in touch and we will get back to you as soon as we can.
Get in touch*We are fully committed to keeping everyone safe and following GDPR guidance during this period of therapy adaptation. We will endeavour to use digital platforms that offer secure virtual spaces but will check with you to ensure you are happy to use the platform that works best for you. There will be no personal or sensitive data exchanged over virtual session spaces.