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If you are aged 18 or over, are female (or identify as female) and are in need of
emotional support then we may be able to help you. Once we receive your completed referral form we will be in touch within 2 weeks to arrange an assessment.
Click on the link below to open our referral form
Once you have completed the form, download it by clicking on the download button in the top right hand corner (see image below) and choosing "With your changes".
Save it to your computer / phone / tablet then open up a new email, attach the file
and send it to [email protected]
If you have problems with the PDF version, you can download a word version here.
Contact the office if you have any problems
If you are a professional and want to refer one of your clients, please complete the form below to the best of your knowledge and email it to [email protected]
You can use EGRESS free if you wish to send this information securely.
We will contact your client within two weeks to arrange an assessment.
If you have any problems with the PDF format you can download a Word version here
- Thank you -