Phase 2 referral portal

If you have any issues with the below form please email or call 01597 824411

Please note - if you are unsure please put 1:1 worker, as they will talk to the client about what matter about their mental health, and assign other services accordingly
If we have any issues with this form we will contact you via email
This information will not be used against you and will be made anonymous when used with our funders
If you have any concerns with the way information is stored, or if they have any questions about your data please get in touch via