External Referral Form

Our London, Bristol and Digital team in East Anglia and West Midlands are currently closed for referrals. If you need help please contact us on live chat or email gethelp@akt.org.uk.
Young person's details
If the Young Person has had a condition for more than 12 months.
Young person's contact information
The post code must be in a valid UK format to submit the form (or it can be left blank).
Include name, relationship and contact details
Details of referral
Referrer Details