top of page
Adult Referrals

Make a referral for an adult

Details of the patient(s) you are referring - PATIENT 1

Is it OK to say who we are on a call??
Is it OK to send patient texts?
Is it OK to leave messages on answer phone?
Can we write to the patient at their home address?
Is partner aware of the referral?

Reasons for referral

 

Please give details of the reason for your referral including any information that might be useful to us such as: medication the patient(s) is/are taking that may be impacting their relationship, other support agencies that are involved, details of any domestic abuse that has taken place or any child protection issues.

Thanks for submitting your enquiry. Someone from Relationships Therapy North will contact you shortly to follow up

bottom of page