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Completing the following referral form should take 10-15 minutes.
We ask a range of questions about various aspects of your mental health and your life in general. We appreciate that it might seem like a lot of questions to answer but the information you provide allows us to offer you the right services for your needs.
If you would like further information please email us on firstname.lastname@example.org.
Due to government guidelines on Covid-19 and social distancing, we have been working alongside our partner organisations to create an alternative offer of online support that can be accessed remotely.
Please complete the referral form and screening questions and you will be given access to these resources. You will be offered free access to a wide of range of online resources that focus on the management of anxiety, low mood and stress.
This new online offer of support will include:
Please note that you will not be contacted for an assessment to access this online support. We’ll send you an email with an access link to each resource as and when they become available.
If you are at immediate risk please contact emergency services or go to A&E. For urgent support or if you are in crisis or distress please contact the City & Hackney Crisis Pathway Service 24 hour helpline on 020 8432 8020.
Please note our mental health and wellbeing services are only available to people who live in the borough of Hackney or the City of London.
Residents of Waltham Forest are able to access our Rainbow Mind, IRIE Mind, education, employment and welfare rights services. If you do not live in Hackney or the City of London please contact your local Mind.
Filling out the following questionnaires will help us to determine the right kind of support for you, if you would prefer to discuss them with a member of our team please leave them blank and submit your referral.
(For referrers who are unable to complete these with the person they are referring please enter all scores as 0)
Below are some statements about feelings and thoughts.
Please enter the number that best describes your experience of each over the last 2 weeks based on the below:
In order to complete your referral please press "Submit" below.
You will be contacted as soon as possible. We will attempt to contact you 3 times based on your contact preferences, if we have not been able to speak to you after 3 contact attempts we will need to close your referral.
If you have any queries on your referral please contact 0800 612 6585 or 020 8525 2301.