Welcome!

Below is the referral form for CHESS

CHESS, which stands for Crisis help; emotional &social support, is designed to be a safe, open space for males over the age of 18, who are at risk of suicide. 

The sessions are hosted via zoom and include a mixture of group activities with opportunity to have 1-1 time with a trained clinical support worker. 

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* 1. Referral date

Date
Time

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* 2. Is this an agency referral?

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* 3. Name and contact details of referrer

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* 4. Personal details of the person needing support

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* 5. Is the person at their place of residence at present?

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* 6. Date of Birth of person needing support

Date

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* 7. Gender

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* 8. Ethnicity

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* 9. Next of kin details

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* 10. Do we have permission to make contact with them? **We will only breach confidentiality without your consent if there is imminent risk to you or someone else. For more details, please ask.

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* 11. Has the person needing support been using alcohol/substances in the last three hours?

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* 12. Does the person needing support have any history of violence towards others?

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* 13. What is your preferred time to attend the session? (please note, we will try to accommodate your preferred time slot but this may not always be possible)

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* 14. Has the person needing support used CHESS before?

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* 15. CHESS sessions are hosted on zoom, do you require assistance with accessing zoom?

Thank you for completing the referral form.

The team will be in contact with you soon. Occasionally, our emails may go into your junk mail box so please keep an eye out. If you have not heard from us, please drop us an email at crisis@tomorrowproject.org.uk

We look forward to supporting you.

If you need support between now and then, below are some services that you can use:

For listening support, Samaritans are available 24/7 on 116 123
For text support, Shout are available 24/7 on 85258
In an emergency, please contact the emergency services on 999

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