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Cornwall Mind
Cornwall Mind
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Referral Form

Please enable JavaScript in your browser to complete this form.
- Step 1 of 2

We encourage self referral. If you are a professional making a referral on behalf of someone else, please let us have your contact details in the box below. Thank you.

Difficulties accessing this form?
 
If you have any difficulties accessing this form, please call 01208 892855 and leave a message with your name and contact details and we will call you back.
If you know which service you would like, please tick box(es) below *
Data protection permission *
In view of the way we process and store your data in compliance with General Data Protection Regulation (GDPR), it is essential we have your permission. We take your privacy seriously and promise to never sell your data. You can find out more about your rights, how we keep your personal information and how we keep your details safe and secure by reading our Privacy Policy, which can be accessed through our website or by contacting the office. For more information, or to withdraw your consent to us processing your data, contact the office on 01208 892855 or email: [email protected]
Equality and Diversity Monitoring (Optional)
 
We want to know a bit more about you, to understand who we are engaging with our work, and who we need to work harder to reach. We also want to make sure we understand the needs of all the communities we work with. Completing these questions is voluntary, and the information you provide will be entirely anonymous. Thanks for your help.
What is your gender? *
Have you ever identified as trans? *
What is your sexual orientation? *
What is your ethnic background? *
Do you consider yourself to have a long term health condition or learning difference that has a substantial or long term impact on your ability to carry out day to day activities? *
Which of these categories best represents your experience of mental health problems? (Please tick all that apply) *
Where did you hear about Cornwall Mind? *
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  • Home
  • About Us
    • Vision and Values
    • Board of Trustees
    • Policies and Procedures
  • What We Do
    • Newport2021 MomentsWellbeing Service

      Wellbeing Service Our wellbeing service offers a range of face to face and online, recovery focused groups and activities for people that want to improve their mental health.

    • Bus rideOne to One Support

      One to One Support Working with our community networks, we offer a range of one to one support projects to help people experiencing mental health problems move forward in their recovery.

    • Experts by Experience

      Experts by Experience Ensuring that people with lived experience of mental health are involved and influence the ongoing development of mental health services in Cornwall.

    • Hands around a cup of tea at a table.Suicide Bereavement Support

      Suicide bereavement support in Cornwall.

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Make a donation Fundraise Urgent Help

Referral Form

Please enable JavaScript in your browser to complete this form.
- Step 1 of 2

We encourage self referral. If you are a professional making a referral on behalf of someone else, please let us have your contact details in the box below. Thank you.

Difficulties accessing this form?
 
If you have any difficulties accessing this form, please call 01208 892855 and leave a message with your name and contact details and we will call you back.
If you know which service you would like, please tick box(es) below *
Data protection permission *
In view of the way we process and store your data in compliance with General Data Protection Regulation (GDPR), it is essential we have your permission. We take your privacy seriously and promise to never sell your data. You can find out more about your rights, how we keep your personal information and how we keep your details safe and secure by reading our Privacy Policy, which can be accessed through our website or by contacting the office. For more information, or to withdraw your consent to us processing your data, contact the office on 01208 892855 or email: [email protected]
Equality and Diversity Monitoring (Optional)
 
We want to know a bit more about you, to understand who we are engaging with our work, and who we need to work harder to reach. We also want to make sure we understand the needs of all the communities we work with. Completing these questions is voluntary, and the information you provide will be entirely anonymous. Thanks for your help.
What is your gender? *
Have you ever identified as trans? *
What is your sexual orientation? *
What is your ethnic background? *
Do you consider yourself to have a long term health condition or learning difference that has a substantial or long term impact on your ability to carry out day to day activities? *
Which of these categories best represents your experience of mental health problems? (Please tick all that apply) *
Where did you hear about Cornwall Mind? *
=
Loading

Search our site

  • Home
  • About Us
    • Vision and Values
    • Board of Trustees
    • Policies and Procedures
  • What We Do
    • Newport2021 MomentsWellbeing Service

      Wellbeing Service Our wellbeing service offers a range of face to face and online, recovery focused groups and activities for people that want to improve their mental health.

    • Bus rideOne to One Support

      One to One Support Working with our community networks, we offer a range of one to one support projects to help people experiencing mental health problems move forward in their recovery.

    • Experts by Experience

      Experts by Experience Ensuring that people with lived experience of mental health are involved and influence the ongoing development of mental health services in Cornwall.

    • Hands around a cup of tea at a table.Suicide Bereavement Support

      Suicide bereavement support in Cornwall.

  • Get Involved
    • Work with us
    • Volunteer with us
  • Support Us
    • Donations
    • Fundraise for us
    • Shop & Support us
    • Corporate Partnerships
  • News
  • Contact Us

Cornwall Mind

Cornwall Mind
2A Hamley Court
Dennison Road
Bodmin
PL31 2LL

01208 892 855
[email protected]

Charity Number: 1176942

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Contact Us

Cornwall Mind

Cornwall Mind
2A Hamley Court
Dennison Road
Bodmin
PL31 2LL

01208 892 855
[email protected]

Legal

  • Policies and Procedures
  • Accessibility Statement
  • Terms and Conditions
  • Cookie Policy

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© 2024 Cornwall Mind
Registered in England
Charity No. 1176942

  • Policies and Procedures
  • Accessibility Statement
  • Terms and Conditions
  • Cookie Policy
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