External Referral Form

Our Digital team (except East Midlands) is 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).
Details of referral
Emergency contact
Referrer Details