ONLY COMPLETE THIS REFERRAL FORM IF YOU LIVE IN THE WIGAN BOROUGH, IN THE NORTH WEST OF ENGLAND AND YOU HAVE REFERRED A YOUNG PERSON INTO THE SERVICE
Please note: The waiting list for adults is around 2/3 months.
Adult Referral Form
Family issues and supporting young people can also be difficult, and if you feel that you or any other adult family member would also like support from us, then please fill out the adult referral form below.
(Please note: this form is more compatible with laptops/computers or by ticking ‘switch to desktop version’ when using a mobile phone, as the formatting is different on a mobile phone.)
Health and History
- Step 1
- Step 2
- Step 3