Activity Group Referral Form

Please note: Yoga Class accepts in-house referrals only.

Our Activity Groups accept referrals from Health and Social Care professionals and from FDAMH's other projects (exceptions are noted above).

Please note that some of our activities are also open to carers/family members of people with mental health issues - please refer to activity pages for full details.

External referrals to the Yoga Group are not accepted (due to small group size).

We treat all referrals in confidence.
FDAMH does not share any information with other organisations for their own marketing.
View our Privacy Policy for full details. You may also ask any member of staff for a copy of our Privacy Policy or view it in our Waiting Room.

Client Details

This information will be used to contact the person referred and for service provision (if taken up). It also helps us review our services.
Please provide details of any health information that is relevant to client safety during attendance at the chosen activities.

Referrer Details

This information will be used to contact the referrer about the referral if necessary and to provide statistics about referrers to FDAMH.
Please ensure your email address is correct.
If you would like a copy of your referral for your records please print this page before clicking the submit button.