Therapy Referral Form

Below is the Therapy Referral form you will need to fill in to apply for therapy. As the form is quite lengthy, please make sure you have to hand:

  • Proof of your total household income (PDFs, photo files or digital documents)
  • Your GP Information

If you encounter any problems when uploading your documents, you can also email them to us directly

Please also be aware that before a therapist is allocated to you, you will need to pay for an initial number of sessions in advance. Once you have submitted your therapy referral form, our team will review the information provided and contact you by email to confirm these payments. It is important that you have read our terms and conditions and FAQs before applying for therapy to avoid any delay or confusion in processing your application.

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