Dynamic Support Register Referral Form

This is a self-referral form for the Dynamic Support Register.  

The purpose of the Dynamic Support Register is to identify people who with appropriate, proactive intervention and support can be prevented from unnecessary or inappropriate admission to mental health or specialist hospitals.

Further guidance can be found here.

If you or the person you are referring meets this criteria, please complete this self-referral form.

Unfortunately we are unable to proceed without the person's consent for referral.

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Referrals to the DSR are accepted for people with a diagnosis of a Learning Disability and/or Autism. If you do not have a diagnosis and need urgent support with your mental health you can find support via Coventry and Warwickshire Partnership NHS Trust website - www.covwarkpt.nhs.uk/urgent-advice

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