Before you submit this self-referral form, please take a moment to check your telephone contact details above as assessment appointments are offered by phone. Once your referral is received, it will be reviewed by a senior member of the clinical team. A member of the service will then make contact with you to follow up. Please be aware that that this call may come from a private number. You will receive an automated email response - if you do not receive this please contact the Service on 01383 565403