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.
Birmingham Healthy Minds referral form
If you need any assistance completing this form please contact 0121 301 2525
Once you have completed the form a member of our team will try to call you and if unsuccessful we will post a letter to your given address asking you to call us to opt in.
