Self Referral Form

Please note, this form is only to be completed by the person seeking help from Mindsmatter. We cannot accept referrals from third parties online. If you are a health professional and you would like to make a referral, please contact the local team (please see for contact details)
Mindsmatter cover the following GP practice areas in Lancashire (Blackburn With Darwen, Chorley South Ribble, East Lancs, Fylde & Wyre, Greater Preston, Morecambe Bay and West Lancs) and also St Helen’s within Merseyside.
If these are not an area that you are registered with please visit : to find your local talking therapies service

Personal Details

NB: We will do our best to match the time of day selected, however not all teams have the capacity to offer evening appointments.

GP Details

Further Information