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Referral Form 

We are not a crisis service. Go to the Crisis Support page for sources of help, including NHS 111. 

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Please complete the form below if you would like to access our Young Adults (18 to 25) Counselling Service based in Malton or  our chargeable Options service (which is offered in Malton and Scarborough). ​​

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​Unfortunately, the waiting lists for our Ryedale and Scarborough brief counselling services

are currently closed. New referrals to these services will be returned.

Fields marked with* must be completed.

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Self Referral
Appointment Preferences
Can we leave a message on your phone
How did you hear about us? Required

Thank you for your referral.

Due to demand we will be in touch within 6 weeks to arrange an appointment.

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