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Traveller Cognitive Behaviour Therapy Referral Information

Fields marked (*) are required











If an appointment is made

Is there any reason you might not be able to make it?

Do you know where we are?

Do you need directions?

Would a text reminder of appointment be helpful?

Would providing local transport information be helpful?

We will need to contact your doctor to tell him/her that you are accessing CBT.




If a service is helping you to complete this referral


This information is collected for statistical reasons and no contact will be made with the service without your permission

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