Independent Mental Health Advocacy (IMHA) Referral Form

Independent Mental Health Advocacy (IMHA) Referral Form

    Part 1: Independent Mental Health Advocacy (IMHA) Referral

    1. Is the person:

    YesNoDon't Know

    2. Additional Contacts:

    Part 2: Referral Information

    YesNo

    YesNoNot yetPerson lacks capacity to consent

    YesNo

    Non-binary refers to individuals who don’t see themselves as either male or female. Individuals identifying as non-binary may ask you to use gender neutral pronouns such as they/their rather than he/she. Please do not ask non-binary individuals the sex or gender assigned to them at birth as this is irrelevant.

    Trans male/female refers to individuals who are transitioning to the gender they identify with.

    Pansexual refers to individuals who are romantically, emotionally, sexually attracted to people regardless of their sex and gender identity.

    If you are having issues with completing this form, please go to our Make a Referral page and download a Word copy of our Referral Form. Then, once complete, please email it to office@advonet.org.uk.

    I’m not sure if advocacy is what I need