You can self-refer to our service by completing the self-referral form below.
Please complete all the boxes in the referral form below as fully as possible. You must complete all the boxes marked*.
The referral form will then be automatically sent (by secure email) to the Adult Weight Management and Type 2 Diabetes Prevention Service who will contact you in due course. If you haven't heard from us within 4 weeks or if you have any queries about your referral, please contact the service direct on 01383 674086.
Click here to read our Privacy Notice.