Make a referral

Our support is designed to help you recover and stay well

Make a referral

We understand things may be difficult, but things can get better. We are here to help you.

The form only takes about 10 minutes to complete. Just complete the contact form below and a member of the team will be in touch.

Alternatively, if you would like to speak to someone, call us on 01482 240133 and we can complete a referral over the phone.

Please give as much detail as you are able to. There are no right or wrong answers. We need to understand what feelings you may be having so we can find the best support for you.

For counselling, please contact NHS Hull Talking Therapies on 01482 247111 or NHS East Riding Talking Therapies on 01482 335451

    Choose an area you wish to be referred to:

    Referral to: (Please tick service you wish to refer in to)

    Please note if you would like to refer in to our Housing Service you will need to call 01482 240200. Please note a professional is required to make this referral.

    Referral to: (Please tick service you wish to refer in to)

    Please note if you would like to refer in to our Housing Service you will need to call 01482 240200. Please note a professional is required to make this referral.

    If you are unsure about which service to refer in to, or would like more information please call our Information line on 01482 240133 or email [email protected].

    Client Information

    Do you harm yourself or have you done so in the past?

    Have you harmed or caused injury to others?

    Do you have thoughts of harming yourself or others?

    Do you have any anger management issues?

    Are you a veteran of the armed forces?

    How would you like us to keep in touch with you/the client?


    Do Hull & East Yorkshire Mind have permission to leave a voice message/ send a text message?