How to Use Our Services

The first step to using our services is to make a referral. You can either do this yourself, or someone else, for example, another organisation can do this for you.

In order to use BHI services we will need a little bit of information from you. This will help us decide which project can assist you best.

Please fill out and submit the form below and a member of our staff will be in touch shortly.

Alternatively, please call us on 0113 3070300 to find out how we can help.

To use our COUNSELLING SERVICE, please download a referral form:

Counselling Referral Form

If you wish to use our THROUGH & BEYOND (cancer support) services, please use the two sheets below:

Men's Through and Beyond Referral Form

Women's Through and Beyond Referral Form

Referred By *

Name of Service User

Postcode

Contact Number

E-mail address

Ethnicity

Date of Birth

Which service do you wish to use

Send to e-mail address

If you are completing this form for yourself, please type SELF in the Referred By box.

You do not have to leave a contact number but if you don't, please let us know your email address.

Please let us know which service you would like to use. For example, counselling, pregnancy testing, STI testing, womens health, men's health, c-card, condom pack collection. If you have left us your telephone number, you may also want to let us know the best time to call.