Refer someone to us

For GPs, social prescribers, link workers and other health and care professionals. It takes about three minutes, and you will get a reference number straight away.

Urgent or clinical concerns? Please call us on 07753 388692 and use your usual urgent pathways. This form is for non-urgent referrals. In an emergency, call 999.

1. About you

Your name

Your role

Practice or organisation

Your phone number

Your email address

2. The person you are referring

Full name

Date of birth

Phone number

Email address (optional)

Postcode (optional)

3. The referral

What are you referring them for? Golden Moves supports strength, balance and falls prevention. The lower back pain class suits persistent, non-specific back pain.

Reason for the referral A few lines are enough: the main problem, how long it has been going on, and what you would like us to help with.

Relevant health information (optional) Only what we need to keep them safe, for example heart or lung conditions, osteoporosis, dizziness or relevant medication. Please do not include NHS numbers.

Any falls in the last 12 months? (optional) Yes No Not known

Getting around (optional)

Support needs (optional)

Or call 07753 388692

What happens next

You get a confirmation email with a reference number.
A member of our team is in touch with the person to arrange the next step.
If we need anything else from you, we will contact you using the details above.

Refer someone to us

What happens next

Ready to get moving again?