Referral – Canopi

Canopi provides a free and confidential mental health support service for health and social care workers in Wales.

Please note, we are not an emergency service. If you need help immediately, click here.

Self-Referral form

Need to talk? Fill in the referral form below and one of the team will get in touch.

Please also note: to assist us in providing the best possible service, Canopi will not usually accept self-referrals where individuals are already receiving or are about to start psychological treatment or therapy from another care provider or source of support. In these instances, we would encourage you to discuss the reasons you are seeking additional help with your existing care provider or your GP.

Referral

Before submitting your referral, please confirm the following:

I, as the individual wish to receive mental health support from Canopi.

If you feel that you may be experiencing a crisis, please dial 999 or visit our Help in a crisis page.

I do not think that I need emergency help for my mental health and am able to keep myself and others safe.

I am not currently receiving psychological treatment or therapy from another care provider.

I have not accessed Canopi’s services before/ it has been at least 12 months since I last accessed support from Canopi.

Your full name / Eich enw llawn *

Email / Ebost *

Please confirm your email address in the box below / Cadarnhewch eich cyfeiriad e-bost yn y blwch isod

Confirm Email / Ebost *

Phone / Ffôn *

Profession / Proffesiwn *

Are you employed to work in the NHS or in social care in Wales? / Ydych chi’n cael eich cyflogi i weithio yn y GIG neu ym maes gofal cymdeithasol yng Nghymru? Are you employed to work in the NHS or in social care in Wales? / Ydych chi'n cael eich cyflogi i weithio yn y GIG neu ym maes gofal cymdeithasol yng Nghymru?

Where did you hear about the service? / Ble clywsoch chi am y gwasanaeth?

Have you used the service before? If so, who was your Wellbeing Ally or Therapist? / A ydych chi wedi defnyddio’r gwasanaeth o’r blaen? Os do, pwy oedd eich neu Cymorth Cynghreiriaid Lles neu Therapydd?

What happens next?

Once we’ve received your self-referral form, we will make an appointment for you to have a telephone call with one of our Doctor Advisors.

You will be emailed within one working day, confirming your details, along with the time and date of your telephone appointment.

Please be aware that our response may be in your junk folder.

FAQs

Dr Advisor availability

Canopi Dr Advisor appointments are available between 9am and 8pm on Monday – Friday (excluding bank holidays).

I have not received my appointment confirmation

Please allow up to one working day to receive your confirmation email and check your junk mail folder before contacting the team.

Where will my details be shared?

Canopi is a confidential service. For more information on how we use and take care of your data, visit our privacy policy.