Confidential Referral Form

If you would like to refer to the 12-18 Emotional Wellbeing Service then please download the form at the bottom of this page .

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.

Use this confidential referral form to join York Mind, alternatively download and print this Word version and send it to:

York Mind
Highcliffe House
Highcliffe Court
York
YO30 6BP