Blackpool CAMHS self-referral

Please complete the self-referral form below. All information submitted on this form will be treated with strict confidentiality.

If you have a parent or other adult who can support you to complete the form, they can help you to fill it in or fill it in for you.

If you are unable to complete the form online, you can download a copy, complete and post it to: Options 4CYP, Care of CAMHS Whitegate Drive Blackpool FY3 9ES or email to

Please phone (freephone) 0800 121 7762 if you have any queries - we are available between 9am and 5pm, Monday to Friday. 

You can also contact the CAMHS services to see whether there are any opportunities for you to call in to drop in sessions that they may run.

Blackpool CAMHS self-referral

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