Please only complete this form if you have a Birmingham based GP. Please do not complete this form on behalf of someone else.


If you are already under the care of a Mental Health Team we may not be able to accept your referral to Birmingham Healthy Minds, so please speak to your Mental Health Team before you fill in the online self-referral form. 

If you need any assistance completing this form please contact 0121 301 2525

Once we have received your online referral a practitioner will review this and you will be sent a link via SMS to book an assessment. If you have a specific requests or we need to talk to you beforehand a member of our team will try to call you. 

Deprecated: htmlspecialchars(): Passing null to parameter #1 ($string) of type string is deprecated in /sites/ on line 4715