Child social prescribing self referral

Use this service to refer/self refer a patient under 18 to the social prescribing team.

You may self refer if you are a patient under 18 and require advice, information or support for any of the following:

• Mental Health and Wellbeing
• Social Isolation
• General Health and Fitness
• Home Life and Family Relationships
• Education and Learning
• Keeping Safe/Healthy Relationships

You can use this service if you:

• are registered at the surgery
• are referring a patient under 18 years old
• are self referring and are under 18 years old

Before you start

We’ll ask you for:

• your first and last name, date of birth, sex, postcode, email and phone number
• if applicable, the details of the person you are completing the form on behalf of

Start now

You can also phone us on 01452 840228.