Hull and East Riding CAMHS Professional Referral Form
1. Child and Adolescent Mental Health Service professional referral form (CAMHS)
The personal information collected in this form is secured using SSL (Secure Sockets Layer) encryption – the standard security technology for establishing an encrypted link between a web server and browser. This link ensures that all data passed between us remains private. This is indicated by the https:// url address and the padlock symbol that appears at the top of the page in the address bar. Further information about security can be found at: https://www.smartsurvey.co.uk/security
The Trust will process personal information in line with our fair processing information detailed at http://www.humber.nhs.uk/data-protection.htm
Please be aware that this referral form is hosted by a third party service provider. This provider will collect your IP address and information about your visit to the website. Further information can be found at https://www.smartsurvey.co.uk/privacy-policy.
All data is hosted within the UK.
Note - If you do not press 'submit' on the last page of the form it will not be received and processed by the CAMHS service.
This question requires an answer
1. Priority of referral *