This is a third party referral form for Lancashire LGBT's counselling service & one to one support service.

 

 

This form is for clients who are:

  • LGBTQ+
  • Aged 18 or over
  • Live or work in the Lancashire area and South Cumbria area
  • Seeking emotional wellbeing support from our counselling service, or one to one support service

Please note: If your client is seeking general support (for example, wanting to join a support group) and not interested in emotional wellbeing support from a counsellor or a support worker, please exit this form and contact us via hello@lancslgbt.org.uk

 

Lancashire LGBT is not a crisis service. If your client is in crisis, they must be directed to the relevant crisis services. If your client is seeking immediate support with their mental health please contact 111. 

 

If you have any questions about our services, or this form, please contact our phoneline on 07788 295521

Have you read and understood the statement above *