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Self-Referral form Luton & South Beds CAMHS

Self-Referral form Luton & South Beds CAMHS


Please fill in the form below.

If you have difficulties reading or writing please call 01525 638 613 and a clinician will call you between Monday and Friday between 09:00 – 17:00hrs.

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 01525 638 613. 

Relationship to the young person being referred
Please enter the details of the young person being referred.
Enter your address
Please specify whose number it is (e.g 07xxx xxxx - parent).
A copy of your referral will be sent to this email address.
Can we contact your parents or carers regarding this referral?
Do you receive Special Educational Needs and Disabilities support (SEND support) at school?
Do you have an Educational, Health and Care Plan (EHCP)?
Are you in contact with other agencies / professionals (e.g Edwin Lobo Centre or social care)?
(How are you feeling?)

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 your ethnic origin? Please tick below.
What is your gender?
What is your sexual orientation?
What is your pronoun(s)

What happens to your referral?

  • East London Foundation Trust (ELFT) provides specialist CAMHS services in five boroughs; City & Hackney, Tower Hamlets, Newham, Bedfordshire and Luton.
  • Each service offers the same process for 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 who 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 on T: 01525 638 613.