MENTAL HEALTH ADVISOR SINGLE POINT OF ACCESS REFERRAL FORM

**Please complete the below form using Chrome!**

Please note that information submitted will be used for referral to one or more of the following Life Lounge services: Counselling, Cognitive Behavioural Therapy and/or the Mental Health Advisor Service.  This will follow an initial contact with a member of the Life Lounge Team.

Please note that this form is not suitable in the event of an emergency or if you are concerned that the student is a significant risk to themselves or others. In the event of an emergency on university premises please contact Security using extension 3700 or 666. In the event that the student is not on university premises or you are concerned that the students life is at risk please contact the Police and Ambulance raising a concern for welfare using the telephone number 999, alerting Security afterwards as to the actions you have taken.