Register To Our Service Online

Please complete this form if you would like help from our service. Our NHS-funded therapies are for people aged 16+ who are registered with a GP Practice in Cornwall & the Isles of Scilly.
When you submit this form, a member of our team will make contact within five working days to arrange an appointment.
If you are a GP or health professional referring a patient, please complete the form and we will contact the patient within five working days. If we cannot contact the patient, we will inform you within 15 working days.

Personal Details

We routinely provide questionnaires by email for you to complete before your appointment.

GP Details

Referral Information

Please be aware that we are not an emergency service. If you feel that you are in crisis or in need of more urgent support, please contact your GP or the Community Mental Health Team on 0845 207 7711.
Out of hours crisis numbers;
- Nightlink - Freephone 0808 8000 306
- Samaritans - Freephone 116 123
Please provide a brief description of the current difficulties you are experiencing that you would like to address.

Further Information

Use of Information

By submitting this online referral form, you are agreeing to share your data with the NHS. For more information on how we collect, store and use your data – please see
Please refresh the captcha picture by selecting the arrow if you have difficulties reading the text displayed.