Adult Client application form

So we can provide the best possible service and keep everyone safe, please include as much information as possible. All information provided is confidential and will only be shared with The Therapy Garden Manager, staff who need to know and Chair of Trustees, if applicable.

Client referral 2021 step 1

In the event of sickness or absence who should we contact (if different from ICE or next of kin)?

Referrer details

If this is a self referral please provide details of any social workers, care coordinators, health professionals or GP we can contact to obtain any further information required to assess your level of support needs.