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Recovery Works Interim

Client Registration form


Welcome to South East London mind.  Our Recovery Works service is now part of the Bromley Mental Health Hub.  This means the way the team deliver support is changing.  Please complete the form below and a member of our team will be in touch to arrange a telephone appointment to talk to you about your mental health and what support could be available.  We will respond within 5 working days of receiving this form.

Please note, if you are currently being supported by an Oxleas NHS Trust service, we are unable to provide you with support. If this is the case, please contact your team to discuss your support needs.

Please note that fields with a red * are compulsory and the form cannot be submitted without completing this information.

Please note, we are not a crisis service. If you need urgent mental health support, please contact the Oxleas Urgent Advice Line: 0800 330 8590 or call NHS 111 and select Option ‘2’ for Mental Health. If you are worried you may hurt yourself or others, call 999 or visit your local A&E.

Service Related Information

Your details

Address

Contact

Current support

Additional Information

GP Details

Consent - Demographics

Section to record consent to hold demographic information

Demographic

Partnership Consent - needed for referral

Thank you for submitting this form.

We store and process your personal data in line with the 1998 Data Protection Act and the 2018 General Data Protection Regulations. For a full copy of our Privacy Policy please see https://selmind.org.uk/privacy/ or you can ask for a paper copy by calling 01689 811222

Any information you give about yourself is confidential to South East London Mind and will only be shared with your permission except where required under specific legislation or where there is a risk of serious harm to yourself or someone else.