Referral Form

Our referral form is currently closed for

this block.

Our next block will start in January,

Please use this form if you would like to start courses in the next block.

Participant Section

To be filled out by workshop attendee. All session start week beginning 8th January.
Mr, Mrs, Miss, Ms etc.
Please tell us if there is anything you think we should know to help you participate, for example leaving space at the table for wheelchair access, large print or being closer to the tutor to hear better.

Referring Agency

To be filled out by referrer, if you are self referring please provide emergency contact details.
for instance O.T, CPN, CMHT, Social Worker