Langworthy Cornerstone
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WELLBEING ENABLER - REFERRAL FORM

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    The aim of the Wellbeing Enabler is to work on a one to one basis over an extended period to improve the health and wellbeing of people living in the local area (Claremont, Langworthy, Weaste and Seedley: CLOWS) who have consistent low mood which is affecting their motivation and ability to participate fully in life.

    Participants will generally have related factors such as excessive drinking, weight, lack of physical activity, smoking, isolation, damaging behaviour (gambling, drugs, and other ‘compensating’ behaviours), inability to form and sustain supportive relationships etc. 

    If the participant has severe mental health difficulties or any risk issues requiring specialist support please do not use this referral form and instead contact your local mental health support agencies.

    REFERRER'S DETAILS

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    PARTICIPANT'S DETAILS


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