Adults - Online referral form

We want to make sure that the Referred Person receives the best help possible, as quickly as possible, from the best service for them. The referral form asks for lots of information about the Referred Person in order to achieve this. If you can find somewhere quiet, where you won't be interrupted, this will help.

Thanks for contacting us! We are unable to proceed with the online referral until there has been difficulties with sleep for at least 4 weeks. Please wait until then before submitting a referral. In the meantime, please have a look at the Combined Wellbeing Portal for more guidance and information

Your answers suggest an immediate risk and we would encourage you to call the Crisis Care Team NOW

on 0800 032 8728 Option 1

Alternatively, call 111

This is available 24 hours a day, 7 days a week

Your answers suggest an immediate risk and we would encourage you to call the Crisis Care Team NOW

on 0800 032 8728 Option 1

Alternatively, call 111

This is available 24 hours a day, 7 days a week

Your answers suggest an immediate risk and we would encourage you to call the All Age Access Team NOW

on 0800 032 8728 Option 1

Or text on 07739 775202

This is available 24 hours a day, 7 days a week

Your answers suggest an immediate risk and we would encourage you to call the All Age Access Team NOW

on 0800 032 8728 Option 1

Or text on 07739 775202

This is available 24 hours a day, 7 days a week

Your answers suggest an immediate risk and we would encourage you to call the All Age Access Team NOW

on 0800 032 8728 Option 1

Or text on 07739 775202

This is available 24 hours a day, 7 days a week

Thanks for contacting us! We are unable to proceed with the online referral until there have been concerns for at least 2 weeks. Please wait until then before submitting a referral. In the meantime, please have a look at the Combined Wellbeing Portal for more guidance and information