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North Lincs self-referral form

The NHS North Lincs Talking Therapies service offers a range of talking therapies for common mental health difficulties, such as anxiety, depression or stress. If you are 18 or over, experiencing symptoms of these and would like help to manage them, please complete the self-referral form below. We will contact you within 7 days to see how we can support you.

Prior to completing a self-referral form, please read the self-referral criteria.

This service is only available to people who are registered with a North Lincs GP. If you live in a different area and are not registered with a North Lincs GP, you can find your local Talking Therapies service on the NHS website.

You can also self-refer by calling us. To speak to someone in the NHS North Lincs Talking Therapies team please call us on 03000 216 165. Our phone lines are open 8:30am to 4pm, Monday to Friday, but outside these times you can leave us a voicemail and we will get back to you.

Please note, we do not provide a crisis response service. If you need urgent support then please call one of the following, available 24 hours a day, 7 days a week:

  • NHS: 111
  • The Crisis Team: 0800 804 8999
  • The Samaritans: 116 123.

    Personal Info

    Date of birth

    For example, 15 8 1998

    Contact Info

    Preferred Contact Number

    Are you happy for us to leave a voicemail?

    Would you like to receive SMS text confirmations and reminders for appointments?

    Are you happy for us to contact you by email?

    Other Info

    Interpreter Required?

    BSL Interpreter Required?

    If you live in North Lincs and you don't know your GP, enter "Unknown"

    Are you pregnant or do you have children under 2 years old?

    Are you a veteran?