Referral Form

* indicates a required field

Personal Details

GP Details

We will not be able to accept or process your referral if you are not registered with a Lambeth GP.

Booking your set up call

The next step is we will call you for a 20-30 minute telephone call to check in how you are finding the programme and discuss how you might get the most out of using it.
We will text you a time for this phone call. This will usually be within the next week, Monday - Friday, between 9.15 and 4pm.
Please specify below what days and times you are available for this call in the next week (or suggest other days if more convenient) e.g. Tuesday 10-11, Friday 9-3.30pm, or 'Monday' or 'anytime'. Please offer as many times as you can.
We will then text you an appointment time as soon as possible.