Time To Talk Online Self-Referral Form

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Time to Talk is a friendly and approachable service offering a variety of talking therapies to adults struggling with anxiety or depression in West Sussex. This form allows you to refer yourself to the service. If you have any problems completing it - or have additional needs which would be helpful for us to know about - please phone our admin team on the relevant number below and they will continue with your referral over the telephone;
Horsham and Crawley - 01293 843300 or 01403 227048
Mid Sussex - 01444 251084
South (Adur, Arun, Chanctonbury & Worthing) - 01903 703540
West (Chichester, Bognor & surrounding areas) - 01273 265967

Access Questions

Before going any further please answer the following 5 questions;
You cannot fill in this form on behalf of someone else. This form is not, however, the only way to access the service, people can call on the phone numbers listed above or can be referred via their GP.
We are an adult service and do not treat people under 18 years old. If you are under 18 and wish to access talking therapy please make an appointment with your GP to discuss the available options.
If this is not the case you can find your local talking therapy service by visiting the NHS Choices website at www.nhs.uk.
If you would like more information about this please call in on the numbers given above.
If this is not the case please make contact again when you do have availability in the next fortnight.
If you answered “Yes” to all of the above please complete all fields on the form below to access the Time To Talk service. If not, please do not continue with this form as we will not, unfortunately, be able to accept your referral at this time.
After you submit this form our admin team will contact you by telephone within three working days to arrange an assessment with a therapist. This assessment will take 30-60 minutes and will help us clarify your needs and determine whether this is the best service for you. PLEASE BE AWARE THAT WHEN WE CALL YOU OUR TELEPHONE NUMBER WILL SHOW AS “WITHHELD” ON YOUR PHONE.

Personal Details

If you would like to be contacted via email (regarding appointments and questionnaires only), please provide your email address. Please note, although we can guarantee the appropriate security of our nhs email system, during transfer over the Internet we cannot guarantee the security of the email, or be responsible for the security of any emails once sent or in the patient’s own email inbox.

Further Information

If you ticked any of these conditions your referral may be passed to the Time to Talk Health Team who are part of our service and have additional knowledge of these conditions and their impact on wellbeing.

If you need urgent help or support in a crisis

Time to Talk is not able to offer crisis/urgent support. If you need more immediate support please consider the following;
- Request an urgent appointment with your GP
- Attend your local A&E department
- Contact the West Sussex Mental Health Line on 0300 5000 101 (24 hours)
- Contact the Samaritans on 116 123 (24 hours)
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