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Referral Form 

Please note, we are not a crisis service, if you need immediate support you can contact:

Samaritans on 116 123  or  North Yorkshire Out of Hours Mental Health Helpline 0333 0000 309

The waiting list for our brief counselling services in Scarborough and Ryedale is currently closed - please do not use this form to refer to these services as we are unable to accept your referral. If you are a victim of crime please see this page for more information.


Fields marked with* must be completed.

Self Referral
Can we leave a message on your phone
Appointment Preferences
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