This online form is intended exclusively for use by medical professionals and employers. Self-referrals or applications to the service are not accepted.
Before you begin, it would help to have these details to hand for the person you are referring:
- Details of any medical conditions and/or disabilities.
- NHS number
- GP practice.
To find out information, see: Healthy Working Life programme
For how we handle your information if you submit this form, see: Better Living Service - privacy notice.