The council will use your personal information for the purpose of delivering the service as requested by you by completing this form. Detailed information about how the council handles personal information is set out in the council’s Primary Privacy Notice and Service Specific Privacy Notices which are accessible on our General Data Protection Regulation (GDPR) page.
If you are a GP or health professional, you can refer your patients or clients to the Health Improvement Service using the form below. If you would like to refer yourself to the service please complete our refer yourself form.
Your job title
Your workplace address
Your telephone number (required)
Email address (required)
Please confirm that you have informed the client of the referral
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