AMHAT Referral Form

02476 932 367

We aim to see all ED patients within 1 hour of referral, and patients outside of ED within 24 hours
Is your referral from ED or an emergency?

Call 02476 932 367

Is your patient fit to undergo psychiatric assessment?
i.e. not drowsy or intoxicated - they do not have to be medically 'fit for discharge'
Patient Details
GP Details
Referrer Details
Clinical Details / Reason for Referral

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Any Communication Difficulties?
Any Safeguarding Concerns?
Medically Fit for Discharge / MEC?