1. 1) Self referral form 
  2. 2) PHQ9 
  3. 3) GAD7 
  4. 4) WSAS 
  5. 5) IAPTEmployment 
  6. 6) DWPEmployment 
  7. Completed

Talking Therapies Referral Form

Welcome to Pure Innovations Therapy Service which is part of the NHS Talking Therapy initiative.

We provide support to people aged 18 or above who are registered with a Manchester or Stockport G.P. and who aren’t currently accessing another therapy service. The service is delivered by Psychological Wellbeing Practitioners (PWPs) who provide support for common mental health conditions such as anxiety or depression.

This could be an online, face-to-face, or telephone-based course of guided self-help treatment or a referral to a partnered service. We will listen to you without judgment and make sure that you see the right professional for your situation and get the support you need.

To help us support you, please complete the form below.

Please note: this service is not a crisis service and will not be suitable for you if you are at immediate or imminent risk to yourself or others. If you feel that you are in distress, for example if you feel at risk of harming yourself or others then we would urge you to contact any of the following organisations who are able to offer support:

  • NHS (non-emergency) 111 (24hrs)
  • Samaritans (Helpline) 116 123 (24hrs)

Alternatively, please contact your GP or if in crisis, attend your local A&E department (you may wish to call an ambulance on 999)

If you want to find out more about how we use your information, please see our terms and conditions

The Talking Therapy service is delivered by Pure Innovations who work in Partnership with Stockport Progress and Recovery Centre, Your Support, Pennine Care NHS Foundation Trust, Stockport Women's Centre, and The Big Life Group.

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We will try to contact you by telephone unless otherwise advised. If possible please provide a mobile number in addition to a landline.
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Your GP Details
We are required to notify your GP that you are accessing our service. Please provide permission for us to write to your GP with this information.
Unfortunately if your GP is not listed in the drop down we are unable to offer you support via our service. Please search NHS choices for your local IAPT provider.
Please note that if you don't give permission for us to contact your G.P., this may impact the type of support we can offer.
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Presenting Problem
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About you
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If this is a professional referral please leave your contact details below:
Person making referral:
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Please complete the following questionnaires if you are making a self-referral.

If you are making a referral on behalf of somebody else you do not need to complete these questionnaires.

Contact Telephone: 0161 804 4415

Contact Email: IAPTteam@pureinnovations.co.uk