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Living Well Self Referral Form

1. Living Well Self Referral Form

The Living Well Programme is a course run by Sussex Community NHS Foundation Trust, aimed at adults living with any long term physical and/or mental health condition. 

To be eligible to enrol on a LWP course, you must be:

  • Over the age of 18 years old
  • Registered at a GP surgery in West Sussex, Brighton or Hove
  • A resident in West Sussex, Brighton or Hove
  • Living with a long term physical and/or mental health condition

Please ensure you answer all questions and a member of the LWP team will be in contact within 5 working days. 

If you have any issues, please contact our office on sc-tr.livingwell@nhs.net

Question 1.

Full Name

Question 2.

Email Address

Question 3.

Contact Telephone Number

Question 4.

Address

*
Question 5.

Were you referred by a medical professional?

- Required.
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