Mental Health Recovery Pathway

Our Mental Health Recovery Pathway service provides open-access day services opportunities for Islington residents who experience mental distress

Mental Health Recovery Pathway

Our Mental Health Recovery Pathway service provides open-access day services opportunities for Islington residents who experience mental distress.

Download our flyer

Download the timetable for day services

 

Referral Form

You can write "Prefer not to say" for any information you would rather not give.

Date of referral *

Name of person being referred *

Pronouns

Date of birth *

Address *

What borough do you live in?

Telephone Number *

Email

Gender *

Marital Status *

Ethnic group *

Sexual orientation *

Religion/Faith *

Employment Status/Skills *

Are you a carer? *

• Yes
• No

Do you provide regular unpaid care to an adult friend or family member?

What is Your Mental Health Condition? *

Any other disabilities/health problems

Medication

GP Surgery

GP Phone

Psychiatrist's Name

Psychiatrist's Address

Psychiatrist's Phone

Emergency contact person

Relationship to you

Emergency contact's phone

Do you have any criminal convictions? *

• Yes
• No

If Yes, please provide more details

Do you have any history of drug/alcohol abuse?

• Yes
• No

If Yes, please provide more details

What other daytime activities are you involved in?

Which Islington Mind services are you interested in? *

Are you self-referring? *

• Yes
• No

Name of referrer *

Referrer's Address *

Name of referring agency

Referrer's Email *

Referrer's Phone/Mobile

Does the service user give consent for this referral to be made? *

• Yes
• No

How did you hear about our service? *

Submit