Battle Scars
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Referral Form 
This service is for West Yorkshire residents over 18 only
For more information, please click on the service logo

    This is about the person we will call:
    This is the phone number we'll use. If it's a family member's instead of the person's above, please tell us (you can use the large box below)
    e.g. cutting, burning, overdosing, self-poisoning, ligature etc. This information will help us keep our workers safe.
    If unsure, please select No

    Ethnic background
    This is for statistical purposes ONLY (the worker making the FRESH call will not have this information)


    Professional referrer's details - please ensure all fields are completed
    We will only contact the referrer if we have been unsuccessful in making contact or if we have serious concerns about this person (we will not contact A&E or MIU referrers in this case). In case of immediate risk of suicide the FRESH team will follow the Battle Scars procedures.
    We will NOT proceed with this call unless you are referring with this person's permission
    Click here if you'd like to provide more information about the project to the person you are referring 
    ​
    (printable version available)
Submit

If you are experiencing problems with this form please email us: referrals@battle-scars-self-harm.org.uk
Battle Scars Policies 
​
Privacy Principles
Contact us
Battle scars logo
Registered charity in England & Wales No 1177020 
​Registered charity in Scotland No SC052466


email: info@battle-scars.org.uk
​Tel (information & admin line only): 07410 380747 - office hours
Funded by:
Leeds Compassionate City Awards Health Wellbeing category winner
Battle Scars Leeds Volunteering Kitemark
charity excellence framework quality mark
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​​Website by Battle Scars
  • Home
    • About us
    • Our vision, mission & values
    • Definition of self-harm
    • News
    • Our reports
    • Contact us
  • I self-harm
    • Virtual support groups UK 18+
    • F2F support groups Leeds 18+
    • 16-25s support group Leeds
    • FRESH phone contact
    • Under 16's
    • Workbook for 10-17 year-olds
    • Facebook support group worldwide
    • Addiction programme
    • Order form - crisis cards etc.
  • I'm family/friend
    • Virtual support group UK
    • Dos & don'ts
    • FRESH phone service
    • Questions needed!
  • I'm a professional
    • Training about self-harm or eating disorders >
      • Self-harm training
      • Eating disorders training
    • Want to know more about Battle Scars?
    • Work with young people
    • Supporting young people (over 16)
    • FRESH phone service
    • Support for foster carers
    • Addiction workbook - PDF for professionals
    • How to write a self-harm policy
    • Order printed resources
    • Join the mailing list
  • Resources & more
    • Understanding s/h
    • Managing s/h
    • Self-awareness
    • For organisations
    • Videos & interviews
    • Blogs
    • Gallery
  • Support us
    • Membership
    • Volunteer
    • Feedback about services
    • Onward Mental Health Hub >
      • Onward - the journey
    • Donations
    • Wristbands
    • Social media