Confidential Referral Form

Some of our services have specific referral forms:

• Adult Counselling
• Advocacy

Please use the confidential referral form below to contact York Mind for the following services:

• Adult Coaching
• Children & Young People's Counselling

In the form below, when asked "What service are you interested in accessing at York Mind?", if the service you are seeking is not listed in the dropdown options, it is because it is temporarily closed to referrals.

Alternatively, download and print this Word Version and send it to:

York Mind, Highcliffe House, Highcliffe Court, York, YO30 6BP

Before filling in the referral form please take a look at the different services we have on offer and mention these in your referral so that it can be dealt with more effectively.

Please note we are not a crisis service. If need urgent help then please click here.

If referring on behalf of someone else, please include your name and contact details in the notes section.