Self Referral Form

Thanks for choosing to register with the Staff Wellbeing Hub. This form takes one to two minutes to complete. Your information will be kept confidential within the Staff Wellbeing Hub secure recording system, you also have the option to contact the hub anonymously if you prefer.
If you would prefer to remain anonymous please call us on 0191 223 2030.
Note, this form is received by the hub between 9am - 5pm on Monday to Friday, except bank holidays, if you need immediate support please contact your GP or local Crisis Service.