Clear Mind Derby Professional Referral Form
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Referrals Process

Self Referrals

If you have an enquiry about our service and would like someone to contact you please fill in our enquiry form (name, phone number, email and message) and we will be in touch within 5 working days. 

Professional Referrals

If you are a professional who would like to refer a client into our service, please download the professionals referral form attached to the link below, fill-in and send the form to:

We may contact you for further information 

We understand that for many there is no solitary ”quick fix” when being supported for mental health & social needs. Likewise, we welcome being part of holistic support packages delivered by multidisciplinary teams, consulting (where required) with the referring organisation. Signposting and completing referrals to other organisations and professional services for any additional support requirements will also be completed.

We will also aim to bridge the gap between the client and specialist services where there are long waiting lists for more specialist support.


Your privacy is important to us. Your information is treated with the strictest of confidentiality and in line with our Privacy Policy and Data Protection Guidelines.