Use of cookies

When we provide services, we want to make them easy, useful and reliable. Where services are delivered on the internet, this sometimes involves placing small amounts of information on your device, for example, computer or mobile phone. These include small files known as cookies. They cannot be used to identify you personally. These pieces of information are used to improve services for you through, for example:

Enabling a service to recognise your device so you don’t have to give the same information several times during one task
Recognising that you may already have given a username and password so you don’t need to do it for every web page requested
Measuring how many people are using services, so they can be made easier to use and there’s enough capacity to ensure they are fast.

You can manage these small files yourself through your browser setting.

Current cookies

We use the following cookies on our website –

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Purpose: These cookies are used to collect information about how visitors use our site, which we use to help improve it. The cookies collect information in an anonymous form, including the number of visitors to the site, where visitors have come to the site from and the pages they visited. These cookies may also be identified as originating from dorsethealthcare.nhs.uk More information about Google cookies.

Embedded content and third party cookies

We want to provide interesting and engaging content on our website. On a number of pages we use ‘plug ins’ or embedded media. For example, we embed YouTube videos in many pages. We also provide links to share content with popular social media sites such as LinkedIn, Facebook and Twitter.

The suppliers of these services may also set cookies on your device when you visit the pages where we have used this type of content. These are known as ‘third-party’ cookies. Third party cookies are delivered on behalf of their respective organisations and as such they may change their name and purpose from the cookies identified below, this is beyond the control of Dorset HealhCare.

Cookie: YouTube
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Purpose: To track visitor views, and to remember user preferences when viewing YouTube videos embedded in our website web pages. More information about YouTube cookies.

Cookie: Twitter
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Purpose: To track visitor information and for security authentication. More information about Twitter cookies.

Cookie: LinkedIn
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Purpose: To track visitor information and for security authentication. More information about LinkedIn cookies.

What are your choices regarding cookies

We will not use cookies to collect personally identifiable information about you.

If you'd like to delete cookies or instruct your web browser to delete or refuse cookies or to opt-out of third-parties collecting any data regarding your interaction on our website, please see information below.

Please note, however, that if you delete cookies or refuse to accept them, you might not be able to use all of the features we offer, you may not be able to store your preferences, and some of our pages might not display properly.

For the Chrome web browser, please visit this page from Google: https://support.google.com/accounts/answer/32050
For the Internet Explorer web browser, please visit this page from Microsoft: http://support.microsoft.com/kb/278835
For the Firefox web browser, please visit this page from Mozilla: https://support.mozilla.org/en-US/kb/delete-cookie...
For the Safari web browser, please visit this page from Apple: https://support.apple.com/kb/PH21411?locale=en_US
For any other web browser, please visit your web browser's official web pages.

Alternatively, you may wish to visit www.aboutcookies.org which contains comprehensive information on how to do this on a wide variety of browsers. You will also find details on how to delete cookies from your machine as well as more general information about cookies.

Staff Extranet >

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Here For Each Other staff wellbeing service self-referral form

Please use this form to refer yourself to the Here For Each Other staff wellbeing service.

If you are here to refer a member of your team or a colleague to the wellbeing service, please use our team member referral form.
If you are here to refer a whole team to the wellbeing service, please use our team referral form.

This online referral form is fully secure and all details below will be stored on our secure and confidential system. By completing this form you agree to these terms and to be contacted via any available method.

Once you submit the form we will be in contact with an appointment offer as soon as possible.

Please monitor your junk/spam email folder so you don't miss anything from us.

In line with Dorset HealthCare and other NHS Trusts, our service operates a Did Not Attend (DNA) Policy. If you fail to attend two consecutive appointments without prior notification, you will be discharged from our service. Where possible, we would appreciate at least 24 hours’ notice of any cancellations of appointments in order for the appointment to be offered to someone else.

If you require urgent mental health support, please contact the Dorset 24/7 Connection helpline on 0800 652 0190 or visit our access mental health page for more options.

Return to the "Here For Each Other" staff wellbeing website.

Please note that we are now closed to new Psychology referrals until further notice, if you already have an open referral your treatment will be continued. Please use this form for PHYSIOTHERAPY REFERRALS ONLY

About you

Title *

First name *

Last name *

Date of birth *

Ethnicity *

Please state

Gender *

Please state

Sexuality *

Please state

Religion *

Please state

Your contact details

Work email address *

Personal email address *

Phone number *

Home address line 1 (please do not provide your work address) *

Home address line 2

Town/village *

County *

Postcode *

Your job role

What is your job role? *

Which service do you work in? *

Which organisation do you work for? *

Your health history

GP surgery *

GP surgery address *

Are you pregnant, and/or do you have a child or children under 24 months? *

Pregnant Child under 12 months Child aged 12-24 months No

Do you have any long-term health conditions, such as diabetes, a heart condition or stroke, chronic pain or respiratory conditions? *

Please tell us briefly about your long-term health conditions

Do you have any disabilities? *

Please tick all that are relevant to you

Hearing Learning disability Physical disability Sight Speech Other Do not wish to say

Have you ever received treatment or support from mental health services? *

Is this referral for physiotherapy? If yes, please answer the next question. Select 'Not applicable' if your referral is for other support and continue filling the form

Are you experiencing any of these symptoms?

Difficulty passing urine or having the sensation to pass water that is not there Numbness/tingling in your genitals or buttocks area Loss of bladder or bowel control Impaired sexual function, such as loss of sensation during intercourse Loss of power in your legs Pain that runs down the back of both legs Feeling unwell with back pain, fever or significant sweating that wakes you from sleep I am not experiencing any of these symptoms Not applicable

If you are experiencing any of these symptoms, please contact your GP or call 111 as soon as possible. If you still need physio support after getting advice from your doctor, please contact us at 01202 130130.

If your referral is for physiotherapy and you are not experiencing any of the symptoms above, please describe your main problem and how long you've had it. Also mention if you've seen your GP about it and if this problem is impacting your ability to work or care for a dependent. Please type Not applicable in the field provided and continue filling the form if your referral is not for physiotherapy

Please tell us briefly about that treatment/support

When did you last access that support/treatment?

Is this a referral to the 3Rs course? (A course for staff on sick leave to help them return to work) *

Yes No

Please tell us why you are referring yourself to the Here For Each Other Wellbeing Service today *

Thank you for completing the form. Please press 'submit' and send your referral through to us. We will be in contact with an appointment offer as soon as possible. Please monitor your junk/spam email folder so you don't miss anything from us. If you require urgent mental health support, please contact the Dorset 24/7 Connection helpline on 0800 652 0190.

Mental health and wellbeing advice

Dorset HealthCare University NHS Foundation Trust

Sentinel House, Nuffield Industrial Estate,
Nuffield Road, Poole, BH17 0RB

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