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.
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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.
Mental health and wellbeing advice