Please enable JavaScript in your browser to complete this form.Referer Details:Name *Job TitleEmail address *Phone Number Person being referred:Name *FirstLastDate of birth Email addressPhone NumberClinical / Suporting points of contact:Name *Job TitleContact detailsSupporting Information:Do you as the referrer believe that the person being referred is safe and well enough in their treatment to engage in groups without detriment to themselves and / or others?YesNoWhat does the person being referred want to gain from joining the Better together Project?Are there any risk or safety issues that we need to be aware of?What is the agreed safety plan for the person being referred?Is the person being referred aware of the referral?YesNoSignatureClear SignatureDate / TimeGDPR Agreement *I consent to having this website store my submitted information so they can respond to my inquiry.Please note, the sessions will be led by Active Wellbeing staff and peers with lived experience, they are not health care professionals and cannot diagnose or give advice, the groups are not to be viewed as a substitute for therapy or professional mental health support through your clinical team. The groups are NOT meant to take the place of counselling, skills groups, crisis intervention or mental health care services. We aim to complement traditional mental health services and offer activities to aid in your Recovery that were designed by people with PD. If at any stage you require a higher level of care then you will be supported to connect with your clinical team to ensure further support is gained. Submit