Doctor’s Referral

GP & HEALTHCARE REFERRAL

Refer a patient to It's Your Choice

Please complete the details below and we'll be in touch to arrange the patient's first session.

Patient name Patient age

Class referring to

Your details

Referring GP / clinician name Surgery / practice name

Contact number or email Anything else we should know optional

Details submitted here are sent securely to It's Your Choice and stored in a PIN-protected area.