Health Professional Referral Form

If the person you are referring requires immediate support please call their GP, call the Camden and Islington crisis line on 0800 917 3333 or urge them to visit their local Accident & Emergency department.
Please provide as much information as possible so we can process your referral efficiently. We offer a range of mainly short-term, goal-focused psychological interventions to people who are looking to make changes in their lives. If you are unsure if our service is the right service for your patient or if you have any problems completing this online form, you can call us to discuss this.

Referrer Details

Patient Details

GP Details

Please note, we can only accept referrals for patients registered with a GP in Camden and Islington, or NHS or social care staff working within North Central London.

Further Details

Referral Reason