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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

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