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Self-Referral Form

Which part of Community Living Well Service would you like to refer yourself to? Please make your selection below by clicking one of the buttons: either ‘Talking Therapies’ or ‘Wellbeing Services’.

Talking Therapies

Support with with anxiety, depression, low mood, having trouble sleeping, or living with a long-term physical health problem. Plus, support in finding and accessing physical activity and exercise options.

To refer for therapy or counselling:

You can use Wysa, our helpful referral assistant, who will guide through the referral form step-by-step. Wysa helps you give us more information so we can find the right help for you, and also offers a free self-care app for you to access while you wait for your appointment.


Talking Therapies via Wysa


Or you can complete our standard self-referral form by clicking the button below:

Talking Therapies

After we have received your form we will be in touch within five working days. We’ll send a booking link via SMS or give you a call to schedule an initial telephone appointment.

Wellbeing Services

Peer Support – Peer support groups, wellbeing workshops and activities with other people who have had similar experiences to you; organised to help improve your emotional wellbeing and resilience.

Employment – Advice, guidance and support to gain or retain paid employment, improve employability skills and know your rights in the workplace.

Navigators – Practical support with a range of issues including benefits, debt and housing options. Support to access specialist advice and information.

Wellbeing Services

About self-referral

Community Living Well offers a range of services to support your social wellbeing, physical and mental health needs. We try to make it as easy as possible for you and other professionals to access our services by using a single point of access and including a self-referral option.

If you are 16 and over and registered with a GP in Kensington and Chelsea or Queen’s Park and Paddington area of Westminster, you can refer yourself to the Community Living Well service quickly and securely by completing the self-referral form below. Just select what service you are interested in and then complete the self-referral form. If you are unsure whether your GP is based in Kensington and Chelsea, Queen’s Park or Paddington, please take a look at our list of GP Surgeries in these areas.

After we have received your form we will be in touch within five working days. If you have any questions about the referral process or other part of Community Living Well please contact us.

A downloadable version of the referral form is also available here

If you need urgent help…

Community Living Well is not a crisis service. At a time of crisis, please:

  • call the CNWL Single Point of Access (SPA) team on 0800 0234 650
  • call The Samaritans on 116 123
  • contact your GP
  • attend your local Accident and Emergency (A&E) department
  • or telephone the Emergency Services on 999.


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