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Richmond Borough Mind
Richmond Borough Mind
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Referral Form

*Please complete all mandatory fields

Someone who can be contacted on your behalf in an emergency if you wish
Please tell us about our current situation and mental health concerns.
Please tell us about any other times you have experienced mental health issues, any self-harm, suicidal thoughts or attempts

Click to see what services are available for Adults or
click to see what services are available for Young People

Don’t know? click to see what services are available for Adults or click to see what services are available for Young People

Please select from the services listed below:

Psychotherapy and Counselling: Our waiting list is currently full, we’re sorry we are unable to take new referrals at the moment.

Equalities monitoring questions are anonymised and analysed statistically to help us and our funders understand the extent to which our clients represent the local community we serve.

Ethnic Origin

Religion and Belief

Gender

Sexual Orientation

Health Conditions and Disability

Employment

Financial Situation

Any personal information you share with Richmond Borough Mind will be kept secure and used in line with the General Data Protection Regulation 2018 (GDPR). We may also make contact with other people supporting your mental health to discuss your referral. This information will only be used to assess your needs and the services that you may benefit from. Information about you will be kept confidential and will not be disclosed to third parties without your prior consent except where required by law, or where we are concerned about your safety or the safety of others. You can withdraw or change your agreement for Richmond Borough Mind to hold or process your personal information at any time.

  • I agree to monitoring information being held by Richmond Borough Mind and stored on their database
  • I understand that the following information may be shared with my GP, my care team or emergency services if there is a concern over my wellbeing or safety; or risk to myself or others

The information that we keep is used to ensure that we can:

  • contact you
  • make informed decisions about services and support you need
  • manage risks to your own wellbeing, and others’ wellbeing
  • review services to ensure they are effective
  • monitor numbers of people receiving a service
  • show what the funding was used for

Protection Regulation 2018 (GDPR) and our Privacy Policy.

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Donate e-news Self Referral Crisis Support
  • Home
  • About Us
    • Our Vision, Mission & Values
    • Our team
    • Our Newsletter
    • Our Impact
    • Our History
  • Support Us
    • Donate
    • Fundraise
    • Our Fundraisers
    • Corporate Partnerships
    • Leave a Legacy
    • In memory
  • Support for Adults
    • Our Helpline
    • Connect to Tech
      • IT support & Mental Health Training
      • Training courses
      • Try before you buy
      • Get comfortable with technology
      • Over 50s
      • Digital Pod
    • Psychotherapy & Counselling
    • Richmond Wellbeing Service
    • Journey Recovery Hub
    • Wellbeing Centre
      • Hearing Voices
      • Recovery from Trauma
      • Art Group
      • Relaxation Group
      • Social Cafe
      • Identity
      • Outings
    • Peer Group Activities
      • Wellbeing Walks
      • Mindful Readers
      • Crafty Minds
      • Peer Lunch Club
      • Chatty Minds
      • Mind and Body Mindfulness
      • Become a Peer Group Volunteer
    • Mind n Mortlake
    • Positive Living Group
    • Befriending
    • Carers in Mind
      • 1-to-1 support
      • Take a break
      • Peer support groups
      • Educational Workshops
      • Resources
  • Support for Young People
    • School Workshops and Support
    • Reach
    • Youth Zone
    • Training for Parents, Carers, School Support Staff and Youth Workers
    • Peer Mentoring
  • Training
    • Bespoke training
    • Mental Health First Aid (MHFA)
    • Mental Health and Wellbeing Training
  • Get Involved
    • Job Vacancies
    • Volunteering Vacancies
    • Workshops and events
    • Outreach
    • Service User Engagement
  • Contact Us
Richmond Borough Mind

1st Floor Rear 
UK House
82 Heath Road
Twickenham
TW1 4BW

020 8948 7652
  • Privacy Policy

Website Design © 2023 C27 Media Ltd

Contact Us

Richmond Borough Mind

1st Floor Rear 
UK House
82 Heath Road
Twickenham
TW1 4BW

020 8948 7652

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© 2023 Richmond Borough Mind
Registered in England 7954134
Charity No. 1146297

Website Design © 2023 C27 Media Ltd

  • Privacy Policy