Wellbeing Service Self Referral form
How do I get help from the Wellbeing Service (formally EPMHS)?
If you would like help from our service you can use the following methods:
Select and click on the link for your area which will take you to our secure online form (hosted by the University of York)
Once you have completed the form please close the page/site in order to return to our website.
If you live in Stevenage, Hatfield, Welwyn Garden City, Welwyn, Letchworth, Hitchin, Hertford, Ware, Bishops Stortford, Cheshunt or surrounding villages please click here for the North and East Hertfordshire online self-referral form.
If you live in Hemel Hempstead, Kings Langley, Abbotts Langley, Watford, Rickmansworth, Radlett, Borehamwood, Potters Bar, St Albans, Tring or Surrounding villages please click here for the West Hertfordshire online self-referral form.
Alternatively you can:
- Call our Single Point of Access service on 0300 777 0707
- Pick up a self-referral form from your GP surgeryor ask your GP to make a referral
- Fill in our PDF form below and send it back to us via email or post
To refer yourself by using our online PDF form, you will need to follow the instructions below, step by step:
- To open the self referral form please click here and follow the next steps below.
- Fill in the form (disregarding any messages about "signing" if they appear on your screen)
- Once the form is completed go to "file" and select "print" (Do not click "send")
- In the now open print window, select in the printer list "AdobePDF" or "Cute PDF writer". Then click "print" or "OK"
- A window will open, allowing you to save your document onto your computer. For easy access, select "Desktop" and click "save"
- Once the file is saved, attach the completed form to an email, which you then send back to us at: firstname.lastname@example.org
Please note that unless you are sending the email from an encrypted system, this method of communication may not be secure.
If you are having any difficulties or have any concerns about emailing it back to us, please print out all 3 pages of the form and post to:
The Wellbeing Service Self-Referrals
Single Point of Access
Trust Head Office
99 Waverley Road
If you would like information and self-help tips to help you manage your anxiety please click here.