Request an appointment with a Mental Health Practitioner

Patient Warning

This is not an emergency form. If you require immediate help or are considering self harm, you can seek help and advice today by calling 111 or 999, or the surgery directly surgery on 01332 737777.

If you would like to request a non-urgent appointment with a mental health practitioner, please use this form.

Request an appointment with a Mental Health Practitioner
Registered practice: *

Have you been advised by the surgery to arrange this appointment? *
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