Please note: this form is for professional referrers only — it is not for patients or members of the public to self-refer.
It is intended for use by clinicians, mental health clinics, psychological services, local government, social services, schools, insurers, employers and GPs who wish to refer a patient to Rainbow Clinical Partnership.
Please complete every section that is relevant to your referral — not all sections will apply to every case, and you may skip any section that is not relevant. Required questions are marked with an asterisk (*).
The form takes about 5–7 minutes.
Please note: Rainbow Clinical Partnership is a planned outpatient service. We are not able to accept urgent or crisis referrals. If the patient is at immediate risk of harm, in mental-health crisis, or needs same-day assessment, please do not use this form — instead direct the patient or referral to the patient's GP, the local NHS Crisis Resolution / Home Treatment Team, NHS 111, or 999 in an emergency.
If you are a patient or a family member looking for help, please visit our website or contact us directly — do not complete this form.
