The Hub therapy service is experiencing high levels of demand at the moment and the current wait time for appointments is now 6-8 weeks. It is important that you do fill out the form - we will aim to contact you within 5 working days, for an initial conversation about your needs. Please check you junk / spam email for communications about the Hub. If you do not hear from us within 2 weeks, please email wyicb-bdc.wyh.mentalwellbeinghub@nhs.net or telephone 0800 183 1488 if you need help filling in the form.

 

The following referral form will ask for information about what difficulties you are currently facing to help ensure you get the right care as soon as possible. All mandatory questions are marked as such and questions can be skipped if you would prefer not to answer.

All personal information provided to us will remain confidential and stored on NHS approved secure data servers in accordance with strict NHS policies for managing personal information. Any non-identifiable information is collected and used, for data monitoring purposes only. However, should anything be disclosed which poses a safeguarding concern, we have a duty of care to notify relevant organisations to keep the client and others safe. We will always seek to involve you in this process and keep people informed of actions taken.


The content of these webpages may not be accessible to all users, if you need the content in a different format that is more accessible to you or have any questions please contact us via email wyhubstaffsupport@bdct.nhs.uk or via telephone on 0800 183 1488.

Please note that during completion of the referral form, you will be asked to consent to contact preferences, if at least one method is not consented to, we will be unable to proceed with your referral.

I would like to refer for (tick all that apply)Required

*Please note that you can refer for multiple interventions at one time.

Please note that we can only accept referrals if you have gained consent from the individual.

Details of person being referred

Further Details

The Hub is committed to offering a service which is authentic and relevant to all colleagues across the ICS.

A carer is defined as: anyone who looks after a family member, partner or friend who needs help because of their illness, frailty, disability, a mental health problem or an addiction and cannot cope without their support.

(Please click here to access carer-specific resources)

This includes cases of adoption and surrogacy.
(Please click here to access resources specifically related to the perinatal period)

(Please click here to access resources for veterans and their families)

Neurodiversity reflects the individual differences in the way that we think and learn. People who diverge from the culturally accepted 'norm', such as people with Autism, ADHD, dyslexia, dyspraxia and Tourette's Syndrome are considered to be 'neurodivergent'.

(Please click here to access resources specifically related to neurodiversity)

(Please click here to access support resources for people with disabilities)

(Please click here to access support resources for people with long-term health conditions)

GP Details

No information will be passed on to your GP unless we thought that there were any safeguarding concerns that we were concerned about.

Employment

If you have multiple jobs or are a volunteer, please fill these questions in with regards to the role that makes you eligible to access this service.

Please note: We can only support people who work in West Yorkshire due to funding

Please note that staff from BDCFT can access the BDCFT Staff Support Service.

Wellbeing

If you are interested in any of our groups, please state here

We require further detail about any support received within the last 12 months, including approximate dates that you received this support.

Have you contacted or accessed this Hub before?

Please select all that apply. If you have never contacted or accessed the Hub before, please leave this section blank.

How Can We Contact You?

Please note that we require consent to contact either via phone or email to proceed with your referral.

It is manitory to allow contact via phone

When is the best time of day to contact you?

We aim to contact clients within three working days of receiving a referral. Our service runs Monday to Friday, 9am until 5pm. Please note that you will be contacted within this window from a withheld number. Tick all that apply

If you are referring for individual psychological assessment, what would be your preferred type of appointment?

If you are not referring for individual psychological assessment, please leave this section blank.