Burton and District Mind Referral Form
Please use this form to refer yourself or a client to non counselling projects provided by Burton and District Mind. This includes Eco-Therapy groups, Mindfulness Sessions, Peer Support Groups, and the such like.
Please note that some of the fields below are required to be completed for us to accept the referral.
If you or your client require counselling, please consider the following referral advice:
For NHS funded counselling: self-referral is through the Staffordshire and Stoke on Trent Wellbeing Service on 0300 3030 923, who will carry out a telephone assessment.
For our Low cost counselling, which ranges from £10 - £40 a session (cost is determined on your annual income) with our experienced counsellors call 01283 566696 or use our contact form on our website
Please be assured that your information is kept safe and not shared with third parties without your consent. For more information see
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