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Make a Referral

How to Complete a Referral Form

You will need Adobe Acrobat to view the form.

Please view the guidance notes for each section of the form by clicking on the blue 'i' symbol.

Click on the blue i for further guidance

By completing a referral, you are committing yourself to support KM CAT in meeting the patient's needs.

Provision Only Referrals

If requesting an iPad or iPod App, then please note that we cannot accept the referral unless the e-mail address for the patient's iTunes account is stated (question 12.7.)

Consultation Referrals

The aim of a consultation is to support the referrer when they are unsure how to proceed, and may be face to face, or a phone consultation. The client is not present for the consultation.

Referral Form

Send a completed referral form to acat.service@nhs.net

Please note, if you would like to edit the referral form on a PC, We recommend using Adobe Acrobat Reader DC or Pro DC as these offer the best compatibility with the form.

If your PC opens the form in a browser (i.e. Chrome, Microsoft Edge, Firefox). Please find the file on your PC (Usually under Downloads) and right-click the file and select "Open with" then Select Adobe Acrobat Reader.