Self referral form

Please complete as much as possible or appropriate.
(Please note that compulsory fields are marked by a red asterix.)

If you have any questions that are not addressed by our “FAQ” in the “I need help” section, please always feel free to get in contact. Our telephone number is 020 3906 7676 and we are available to answer question from 9am to 5.30pm; or alternatively you can reach us via email

  • Please note that while The Listening Place offers ongoing support for people in times of suicidal crisis, if you feel you need immediate support please use emergency services (A&E/999).