You may use our online forms to refer to FDAMH.

You do not need to use the online form if:

  • you are in crisis,
  • or you wish to access our IMMEDIATE HELP SERVICE
  • or are unable to complete this form.

In any of these cases please simply Contact Us during office hours.

If you need urgent help when FDAMH is closed visit Need Help Now

Referral Status

  • All services are accepting referrals as normal

Referral Forms

(If you are filling in a referral for a family member or friend with their knowledge and permission, please use ‘Refer Yourself’, entering their details)

(For Health and Social Care Professionals etc. to refer someone you are working with)

Forms for Printing

If you prefer you can use printable versions of our referral forms to send or hand in to us:

Printable Refer Myself Form (pdf)

Printable Refer Someone Else Form (pdf)