Social Networking Service/The Hub Referral Form


Who is eligible? • Adults 18 - 65 years with a mental health problem and • Who are accessing secondary mental health services or who has been within the last two years irrespective of their CPA status. or • Who would benefit from support to prevent relapse, combat isolation, maintain recovery and develop social skills. Who can make a referral? Referrals are accepted from the following: • Health and social care professionals (including G.P.s) • Other mental health services (including voluntary services) where the person has been referred by one of the above

Identity

Address

Demographic

Contact

Service Related Information

Other Information

Consent

Referrer Details