We know that good health and wellbeing can have a hugely positive impact on all areas of your life, and we are here to support you with that.  

Our Wellbeing team can help you to better manage your health by making and maintaining positive changes to your lifestyle. If you feel better, both physically and mentally, you may be better equipped to deal with other challenges you face.    

We can support you to address the underlying issues which prevent you from adopting a healthy lifestyle and we’ll help you to develop your skills. 

While we can help with advice, we are not a crisis service. If you feel your situation is deteriorating or urgent, please contact:  

  • your GP; or the NHS helpline on 111 or go to your nearest Accident and Emergency Department to access Crisis services; or 

  • you can call the Samaritans on 116 123 who can help you talk through whatever is troubling you, find the answers that are right for you, and offer support. 

For your referral to be accepted, all fields on this form must be filled in. 

If you need any help filling in this form, please contact the team on 01977 724403. 

Background information

Are you a WDH tenant?
Have you worked with the WDH Wellbeing Team before?

Other agencies involved

Please give details of any services that you are currently, or have been involved with. This includes pending referrals.

Will current involvement be continuing?

Referrer Details

I am referring myself

Details of person requiring support (please complete all fields)

Gender
Preferred method of contact

What can the wellbeing team help you with?

Lifestyle
Health Issues
Emotional Wellbeing
Life Skills
Relationship Issues
Housing issues

Reason for referral

Joint visit required?

Consent to the referral

You agree to a referral to the Wellbeing Team to be made and to engage with the team to achieve positive outcomes.
You agree that through the process of our support, if appropriate, your personal details may be passed onto suitable partners to enable us to provide you with the relevant support. You have the right to withdraw this consent at any time but you must be aware that we may not be able to then provide you with support.
You agree to WDH checking NHS / Mental Health records to assist with my support?