Make a referral

  1. Introduction
  2. Their details
  3. Their GPs details
  4. Your concerns
  5. How to contact you
  6. Overview

Before we get started

Please respond to the following questions to the best of your knowledge.

Only the questions marked with * are mandatory but all questions will help us respond to you in the best way.

Please note: This service is only available for young people up to the age of 18 registered with a GP in one of the following boroughs: Bexley, Bromley, Croydon, Greenwich, Lambeth, Lewisham and Southwark


After you submit your form, a member of our team will contact you the next working day. If you do not hear from us on the next working day after you have submitted your form, please give us a ring on 020 3228 2545.

Please enter their GPs postcode *

If you don’t know their GP’s postcode, the NHS GP finder is an easy way to get it.

Sorry, our outpatient service 
is not available in your area.

Made a mistake with your GP postcode?
Try again

If you entered the correct GP postcode sorry, our outpatient service is only available for young people up to the age of 18 registered with a GP in one of the following boroughs: Bexley, Bromley, Croydon, Greenwich, Lambeth, Lewisham and Southwark.

There are other specialist eating disorder services in London, please contact your local GP for more information. If you would like any more information on eating disorders, visit our Getting Help page.

Please provide the following information about the young person you are referring.

Their date of birth *


* Required field* Required field – we still need information in the following sections* Sorry, this service is for under-18’s only

Now, please provide some further details.

Please note that we will not contact the school without their permission.

Is there any other health service involved?


* Required field* Required field – we still need information in the following sections

What would you like us to help with?

Has the young person been experiencing any of the following?

Please select all that apply


* Required field* Required field – we still need information in the following sections

Finally, we’d like to know how to get in touch with you.

Is the young person aware of your contact with our team? *


* Required field* Required field – we still need information in the following sections

Overview

Their details

Edit
Their name
Their date of birth
//
Their gender
Their address
Their city or town
Their postcode

Their GPs details

Edit
Their GPs Postcode
The name of their GP or Surgery
Which school or college does the patient attend?
Is there any other health service involved?
How did you hear about the service?

Your Concerns

Edit
What is their current (or last recorded) height in cm?
What is their current (or last recorded) weight in kilograms (kg) or stones (st.) & pounds (lbs.)
Has their weight changed over the last month?
Please summarise your concerns about the child or young person you would like to refer:
Is there anything else you would like us to know that we have not asked you already?
Has the young person been experiencing any of the following?

How to contact you

Edit
Your name
What is your relation to the young person?
Your phone number
Alternative phone number
Your email address
Is the young person aware of your contact with our team?

Please make sure all of the information is correct before submitting the form


Your privacy is important to us. To understand how we collect and use your data please read our Privacy Policy

Congratulations!

Your referral has been submitted, What happens next?

Once you’ve submitted your form, we’ll get in touch on the next working day to schedule your first appointment. If you haven’t heard from us by then, please call us on 020 3228 2545. Our office is open Monday to Friday, from 9am to 5pm.

Once we’ve approved your referral, we’ll aim to get you booked in to see us within 28 days unless we feel we need to see you very urgently in which case we will arrange to do so within a maximum of 7 days.

Your handy downloadable information pack will tell you everything need to know about your first appointment with MCCAED. Please make sure you read it thoroughly!

We look forward to meeting you in person.

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