Refer yourself

Plymouth Options is for everyone aged sixteen or over, who live in Plymouth and are registered with a GP in the city.
You can self-refer to Plymouth by completing this secure form. The form takes up to 10 minutes to complete. If you do not have a mobile number please contact our service by calling 01752 435419 to complete your self-referral.
If you are a GP or health professional referring a patient, please complete the form and we will contact the patient within 5 working days.

Reason for Referral

Tell us about you

How may we contact you?

We’d like to keep you updated about your care at every step.
The NHS uses an encryption feature for all emails to correspond securely.

Emergency contact

In the event of an emergency, please provide the details of someone who we can contact – ideally someone who lives nearby you.

Additional details

We ask these next questions to make sure we’re doing our best by reaching out to everyone in the community.

How else could we help?

We support people with a wide range of needs, and we’d like to be as helpful as possible.