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Self-Referral form Bedfordshire CAMHS

Self-Referral form Bedfordshire CAMHS

Childrem

Please fill in the form below.

If you have difficulties reading or writing please call 01234 893362 and a clinician will call you between Monday and Friday between 09:00 – 17:00hrs.

Once completed, please email us the form – elft.spoebedfordshire@nhs.net. 

If it is an emergency please go to A&E or tell a responsible adult or someone you trust. In non-emergencies please contact NHS 111 which is an out-of-hours service. Take a look at our list of services that can help.

If anything changes once you have completed the form and sent it to us, please call us on T: 01234 893362 

Relationship to the young person being referred
Please enter the details of the young person being referred.
Please specify whose number it is (e.g 07xxx xxxx - parent).
A copy of your referral will be sent to this email address
Do you receive Special Educational Needs and Disabilities support (SEND support) at school?
Do you have an Educational, Health and Care Plan (EHCP)?
Do you give consent for CAMHS to make contact with the agencies / professionals or social care involved in your child’s care?
Are you in contact with other agencies / professionals (e.g Child Development Centre) or social care?
(How are you feeling?)
What have you tried previously? Please tick what's appropriate

This section is for our monitoring purposes, please complete as much as you want to. Don’t worry if you cannot fill it in, this will not affect the support we are able to offer you

Do you need an interpreter?
What is the young person's ethnic origin? Please tick below.
What is the young person's Gender?
What is the young person's Sexual Orientation?
What is the young person's Pronouns?

What happens to your referral?

East London Foundation Trust provides specialist CAMHS services in five boroughs; City & Hackney, Tower Hamlets, Newham, Bedfordshire and Luton. Each service offers the same process for the safe consistency in the management of referrals; this is via a local Single Point of Entry (SPOE).

All referrals are discussed with the young person, their family, and/or the referrer in order for the specialist clinical triage team to gather all relevant information, this helps inform the team to make a detailed clinical decision regarding the most appropriate treatment pathway for your presenting need based on risk to ensure your referral receives the right help at the right time. Once a decision has been made you will receive confirmation from the team to inform you of the outcome of your referral, this may include offering an episode of care within CAMHS or signposting to local services that are better suited to meet your needs.

A copy of the clinical decision-making will be sent to you and copied to your GP for continuity of care.

If anything changes once you have completed the form and sent it to us, please call us at T: 01234 893362