You can Refer yourself by completing the form below, if you require to post the form please see the download at the bottom of the page of whitch you can print off and fill in and post to our Head Office as stated on the referral documentation.
Please be aware that the Philippi Trust is a Charity and receives no funding from any agencies. To access the Services we request a minimum donation of £20.00 per session to cover our operating costs. There will be an initial payment on when the assessment placed and then payments will be a week in advance of appointment.
If you have the ability to Gift Aid the trust will also benifit from this recieving an additional 25% of your total donations.
Background Information – Confidential
Please do not be anxious, if you have difficulties at all in completing this form, please telephone the office and we will offer all the help we can. Contact details are requested to help safeguard your right to confidentiality. Please tick the appropriate boxes – if none are ticked we will not be able to contact you to offer you your appointment.