Self Referral Form

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.
By completing and submitting this form you are consenting for your information to be stored on our confidential service database. This information is held securely and is not viewed by anyone outside of Turning Point.
Please be aware if you do not give consent, we may still need to speak to other professionals if we feel there is any risk of harm to or from yourself or others, or where a crime has been committed. We would always try to contact you first before making such a decision.
* = Mandatory Fields

Personal Details

Are there any days and times that you absolutely cannot be contacted:

Additional Information

About You

We will endeavour to look at all online referrals within 48 hours, after which we will attempt to make telephone or email contact with you in order to arrange for an assessment.
Please be aware if you do not give consent, we may still need to speak to other professionals if we feel there is any risk of harm to or from yourself or others, or where a crime has been committed. We would always try to contact you first before making such a decision.
By completing and submitting this form you are consenting for your information to be stored on our confidential service database. This information is held securely and is not viewed by anyone outside of Turning Point.