Client Referral Form
Please complete all sections to access Community Strength support.
On completing this form,  you are expressly agreeing that you have given permission for Eight Bells Community Strength to hold your personal information in connection with being a client of this organisation.  Your personal data will not be shared with anyone unless you have given explicit consent to do so.  Eight Bells will hold this data for the duration of your time as a client or until you withdraw permission. You can withdraw your permission at any time by contacting 

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This form was created inside of Eight Bells for Mental Health. Report Abuse