This form is for GP Referrals to the IAPT service. It cannot be printed and sent by post and must be submitted online.

Oxleas referral cannot be accepted without an uploaded assessment.

This service is not suitable for patients with: active risk to self/others; a current diagnosis of psychosis, personality disorder or organic mental disorder; alcohol and/or drug dependence. We are also unable to treat multiple/complex trauma, hoarding, eating disorders (e.g anorexia/bulimia) in Step 3 IAPT. These patients should be considered for Oxleas and patients with Forensic history should be referred to the Bracton Centre. Patients with drug and alcohol problems should be referred to Nexus/Signpost only. Patients should NOT be referred to multiple services. Please also note that we are unable to provide diagnosis or medication advice

Please provide details of all current and previous support from other organisations’

Drug / alcoholSecondary Mental Health service (e.g. Oxleas)CRUSEWomen’s Aid/Freedom ProgrammeFamily MattersOther (give details below)

If Yes, or any other support received -‘Unfortunately, we are currently unable to accept this referral as the client is already receiving support elsewhere’. Please call the IAPT department if you need to discuss this further.