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Client Details

Name
Address
Contact permissons

Eligibility check

Do you/they experience mild to moderate mental health issues?
Do you/they experience money worries?
Does your/their mental health affect money management (e.g. social anxiety, overwhelm, fear of contacting people etc.)?
Are you currently in mental or financial crisis?
Are you willing to engage in guided self-help?
Reason(s) for referral

GP Details

I give consent to contact my GP
Do you (or the client) present any risk to yourself (or themselves) or our staff who will work on this project?
Do you identify as a person with a disability or other chronic condition?