Professional Referral Form for Deaf People

Patient Details

Referrer Information

Registered GP Details

Further Information

Next of Kin

Referral Information

If your patient is self-harming or has suicidal thoughts, please refer to your relevant Mental Health Service or patient can contact SHOUT text DEAF to 85258 for free and immediate support. IMPORTANT (SignHealth Psychological Therapy Service is not a Crisis Service).
We will be in touch with the patient within the next 7 days.