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Referral Form
Please note, we are not a crisis service, if you need immediate support you can contact:
Samaritans on 116 123 or North Yorkshire Out of Hours Mental Health Helpline 0333 0000 309
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The waiting list for our brief counselling services in Scarborough and Ryedale is currently closed - please do not use this form to refer to these services as we are unable to accept your referral. If you are a victim of crime please see this page for more information.
Fields marked with* must be completed.
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