Self Referral Form

Self Referral to Sutton Uplift

Sutton Uplift Self Referral Form

Brief questions to help understand the support that would suit you

Please let us know if you want support to complete the form

Contact Details

Your Support: Who supports you?

About You - This helps us to check if our service is reaching out to wide ranging people

About Us: The services we provide include:

*Wellbeing – practical support to reduce stress (time mgt, balanced life) or helping you to access activities/ services that improve your wellbeing (vocational, social, leisure or active opportunities, support groups, housing)

*Psychological Therapies – various individual and group therapies for depression and anxiety based difficulties

*Psychiatric Assessments - for those with more serious mental health difficulties

Your Support Needs

(you can select both)
(Please add as much detail as possible so we can ensure you access the best support)
(e.g. physical health issues, sign language, travel, concerns regarding your safety, interpreter [specify preferred language], relative/friend speak on your behalf – please provide the name)
(You can choose more than one)

How to
Self Refer

Find Out More

Professional Referral Form

Find Out More

About
Uplift

Find Out More

A Partnership Between:

  • South West London and St George's Mental Health Trust
  • Recovery College
  • Imagine Independence
  • Sutton Age UK
  • Off the Record
  • Sutton Carers Centre