Referral Form for East Lancashire Mental Health Support Service

Who is this referral form for?

Please note, this particular referral form is intended for Creative Support’s Personalised Support Service in East Lancashire. If you require a service operating outside of East Lancashire, please contact our Head Office on 0161 236 0829 who will re-direct you to the service you require. This online referral form is intended for mental health professionals and other agencies working in East Lancashire.

Supporting Documents

East Lancashire Referral Pack (pdf)

Cofidentiality and Privacy

The referral form below uses a system provided to us by www.formsite.com. The system is fully encrypted using a technology called SSL. This means that when you fill out the form and submit it, the information is sent and kept in a secure manner and will remain confidential.

Only authorised Creative Support personnel will be able to view the information sent via this form.

Referral Form

<a href=”https://fs21.formsite.com/CSWebmaster/form356842051/secure_index.html” data-mce-href=”https://fs21.formsite.com/CSWebmaster/form356842051/secure_index.html”>Click here to complete: East Lancashire Referral Form – For Professionals</a>



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