Talk Wandsworth Self Referral Form

NB: This is a self-referral form. If you are a professional, please use eRS or alternatively the professional referral form (if you do not have access to eRS) on our website.
* indicates a required field

Personal Details

GP Details

(please note in certain circumstances (such as where significant risk is identified) we will be obliged to share information with your GP)

About You

Your Support Needs

Additional Information

If we feel that another Trust service is better placed to help you at this time, we would like to refer you directly to them. Please select this option if you DO NOT want us to share your information in such circumstances.
In order to reduce waiting times and ensure timely assessment and treatment, we work closely in partnership with digital providers. These providers are currently Xyla digital therapies, IESO and Silver Cloud.