To access counselling you can complete this referral form. You can complete this yourself, or this can be done for you by a family member, GP, Social Worker or someone else. The information is confidential.
Your referral will not be picked up over the weekend or at times when our offices are closed. If you need support urgently please contact Lifeline on 0808 808 8000.
If you would prefer to complete a form offline, please download the PDF referral form.