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O N L I N E   R E F E R R A L

If you have any questions or concerns before completing the form please feel free to send us a message through the chat facility. If you have any questions about how we collect and store your data you can read our privacy policy here.  Alternatively, you can email us at 

Please note that we cannot accept referrals where there is an active significant risk of harm or suicide.  If you feel at risk to either yourself, toward or from others, please contact your GP, NHS111, or dial 999 in an emergency.

Thank you. We will be in touch with you as soon as possible.

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