Referral Forms
Please use one of the referral forms below by downloading your chosen form to a computer and either filling out the Word document and emailing it to us, or printing it out and posting it to the address on the form.
Adult Psychological Therapies Self-Referral Form
To download the form, right click a button below and ‘Save As’ to your computer
ASD and ADHD Service Self-Referral Form
To download the form, right click a button below and ‘Save As’ to your computer.
Adult Autism and ADHD Service Self-Referral Form
To download the form, right click a button below and ‘Save As’ to your computer
Children and Young People
If you are a parent or carer and you would like to make a referral, please phone us and we will be happy to speak with you. We can explain more about our service, help you decide if it is the right service for your child/ young person. Then if you would like to make a referral, we can take this referral from you on the phone and arrange therapy for your child/ young person.
If you are a professional and you want to make a referral, please phone us and we can explain how we may be able to help. We can then send you a referral form.
You can contact us by phone or email.
Our telephone number is 01904 412551, Option 3 for the Children and Young People’s Therapy Service
You can send an email to CYPInfo@theretreatyork.org.uk
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Ask a question or book an appointment below. For out of hours enquiries, please email outpatients@theretreatyork.org.uk