Psychological Therapies Service

We are not a crisis service. If you need immediate help to keep yourself or others safe please call NHS 111, your GP, or go to your local Accident & Emergency department. If you feel yourself or others are at imminent risk of physical harm please call 999.
All questions marked with a * are required.

Consent

This service keeps the information that you share with us on a dedicated computer system to ensure that it is stored safely and securely. This is only accessed and used by the IAPT team to plan and monitor your treatment. Information from this assessment and your future care is shared with your GP so they are informed about any treatment you are receiving. We may also want to share information with other professionals who need to be involved in your care to ensure that you receive the correct treatment at the right time and we will ask your permission to do this. On occasions we may need to share information with other professionals without your permission if we are concerned about your safety, the safety of another person, or you inform us that you have/or are about to, commit a serious crime. Should this be the case we will discuss this with you first and involve you in the process if possible.

Risk

Client Details

Parent/Care Information

Contact Details

Client Medical Needs

Social Care Information

Preferred Contact Times

GP Details

School Information

Referral Details

Additional Questions