Referrals are now only accepted directly from GPs, the Sexual Health Service and secondary care services (e.g. gynaecology, urology, endocrinology, etc). All other referrrals must be by GP only.

Contact us at 01253 958020 or email bfw-tr.shareblacklancs@nhs.net.

You can write to us at: Acorn PHCC, 421 Blackburn Road, Accrington, Lancashire, BB5 1RT.

Date of referral Required
Required
Full address of referrer Required
Required
Required
Required
Does the patient/client give consent for SHARE to contact their GP?
Required
Patient's address Required
Patient's date of birth Required
Patient's ethnicity Required
If the patient has a partner, is the partner aware of the referral?
If the patient has a partner, is the partner willing to attend with the patient?
Is this patient a veteran? Required
Required
Required
Required
Required
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Required
Required