SBS - Leeds Mind Suicide Bereavement Services - Referral Form

**REFERRALS AND THE EMAIL INBOX WILL NOT BE MONITORED BETWEEN TUESDAY 23RD OF DECEMBER AND SUNDAY 4TH OF JANUARY. IF YOU MAKE A REFERRAL BETWEEN THOSE DATES, WE WILL CONTACT YOU WEEK COMMENCING 5TH OF JANUARY**

If you are completing this on behalf of someone else as a professional, please enter their information and then note your own contact details in the end section of the form.

Please contact SBS@leedsmind.org.uk if you have any questions about this form.

Once you have completed this form, a member of the team will get in touch to arrange the next steps.