Mosaic self-referral

You can use our online form to:

  • self-refer
  • submit a self-referral on behalf of someone else with their consent
  • submit a self-referral in your professional capacity, for example GP, nurse or mental health worker

When you submit the form, Mosaic will contact you within 2 working days.

If you are in crisis

If you feel you need urgent assistance, please contact your GP or attend your nearest A&E department. You can also contact:

  • NHS 111
  • Samaritans 116 123

Before you start

If you're aged 26 or over, you can read information about getting support over aged 26.

You can use this form if you or the person you're submitting the self-referral for:

  • live in Stockport
  • are under the age of 26
Start now

How we use your data

We primarily use your data for processing your request. All information is processed in accordance with our Mosaic privacy notice. We never sell your data to third parties or use it to market to you without your consent.