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City Stabilisation Service

This is the referral form for the Nottingham City Stabilisation Service. Please provide client and referrer details below and our team will be in touch once we have processed the referral.

Client Date of Birth(Required)
Client Address(Required)
Is it safe to contact the patient by
Interpreter needed
Date of Assessment by Mental Health Professional(Required)
Please upload a copy of the client’s most recent assessment or notes detailing this client’s presentation and risk. Where a risk to self and/or others is indicated please include risk management information and dates of most recent concerns so that we can ensure the patient, staff and other patients are safe. ***Referrals submitted without a recent assessment will not be accepted***
Max. file size: 5 MB.
Please upload a copy of the Client’s most recent assessment.
Has this person been referred to City Stabilisation before?
Client Risk and Needs Summary – please tick all that apply(Required)
Referring Team(Required)