№ files_lp_3_process_7_001957
Administrative referral form collecting personal, clinical, risk and equal opportunities information for access to a mental health peer support service in Derbyshire.
Organisation: Derbyshire Recovery Peer Support Service
Contact Email: [email protected]
Postal Address: The Croft, Slack Lane, Ripley, Derbyshire, DE5 3HF
Contact Telephone: 01773 734989
Document Type: Referral Form
Service Area: Mental Health Peer Support
Applicant Information Required: Personal Details, Contact Information, MH Diagnosis
Referral Types: Targeted 1:1 Support; Targeted Telephone Support; Access to Peer Support/Groups
Risk Information: Risks to Self, Others, Substance Misuse
Equal Opportunities Monitoring: Gender; Ethnicity; Religion; Sexuality; Employment Status
Data Protection: Information processed and held in line with Data Protection Policy
Intended Users: Referrers, Self-Referrers, Service Staff
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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