Self-Referral Form: Devon

1. Welcome

We know this isn't where you want to be right now and this isn't a form you want to complete.

We're also really sorry that you find yourself having to do so.

This form will probably take you a maximum of 10 minutes and saves you from having to say things out loud that you may not be ready to say to a stranger just yet.

If you have any problems with this form, you can call our office to on 01395 277780.

You may want to gather the following information together before you begin:
- Contact details of your GP & surgery
- Contact details of an emergency contact (this can be your GP)

We will also be asking some very simple questions about the person who has died by suicide. 

Please only complete this form if you are interested in ongoing support for the impact of suicide. If you are looking for advice or you were going to complete this form on behalf of someone else, please either use our website enquiry form or telephone our office on 01395 277780.

Grab yourself a nice cup of tea and maybe think of something nice to do for yourself, once you've finished.