Date Received:
PATIENT / REFERRER / GP
Name:
NHS No.: / Job Title
DOB:
Address:
Postcode:
Telephone:
If referring family members, please provide details of each person e.g. DOB and/or NHS No
Reason for Referral/Desired Outcomes (please provide as much information as possible):
Has the patient been asked if they wish to see a psychologist? Yes/No
Do they agree? Yes / No
Has patient had previous contact with this or any other psychology/counselling service Yes / No
If Yes, please give details:
Relevant medical history (e.g. main disabilities/diagnosis + date of onset)
Please attach relevant medical letters. Attached? Yes / No
Any risk/complex issues (e.g. forensic background, drug/alcohol use, history of violence or abuse)
Other Contacts/
Relevant Professionals
e.g. Main Carer,
Care Manager / Name + Position / Address + Postcode / Tel. No.
About the Department of Clinical Neuropsychology
at the Oxford Centre for Enablement (OCE)
Who do we see?
We see people who have psychological problems associated with acquired brain injury (e.g. head injury and stroke) and long-term neurological conditions (including a wide range of progressive and developmental conditions).
We see patients who are already accessing services at the OCE (e.g. day patients of the Continuing Disability Management Service) as well as those living in the community. We also accept referrals of family members of patients accessing this service, including children.
Common reasons for referral
- Neuropsychological assessment to help identify cognitive problems, arising from brain injury or disease
- Cognitive rehabilitation this may be on an individual basis, or as part of our Cognitive Rehabilitation Group
- Psychological assessment and management of troubling emotions (such as fear, depression and anger) or health related problems (such as pain and fatigue) arising in the context of neurological illness
- Specialist counselling to deal with issues arising from life changes, relationships and the impact of neurological illness
- Family Support Service for both child and adult relatives
We also have access to the resources of a multidisciplinary team (including doctors, occupational therapists and physiotherapists) with whom we frequently work to help our patients.
Who refers?
We encourage referrals from GPs where possible however we do accept referrals from a range of community professionals e.g. specialist community nurses. Referrals should be made in writing on this form and discussed with the patient first. If in doubt about the suitability of a referral, please contact us on 01865 737365. Patients are generally seen in the order that they are referred, although urgent matters will be given priority.
What we need from you
Information is key in making appointment decisions regarding referrals. Limited information or lack of clarity as to what aspect of service you are trying to access will result in delay.
What happens next?
We may contact you to discuss this referral in more detail. We will then write to you and the patient informing you that the referral has been accepted and they have been put on a waiting list. An appointment will be sent in due course.
We aim to acknowledge all referrals in writing within 14 days; the response may include referral to a more appropriate service.
If you have any concerns or queries regarding this referral, please contact us on 01865 737365