HCP Referral Form
Penny Brohn UK Preparing for Treatment Programme
We have updated the way we accept referrals and encourage clients to self-refer where possible. Evidence from our pilot shows that self-referred clients are more likely to engage with the programme.
If you already have consent from your client to pass on their details, you are welcome to complete the form below. However, please note that this form will eventually be removed as we transition fully to self-referral. In the meantime, we’d encourage you to share the link below with your patients so they can read about the programme and sign up directly.
If you need to refer a patient into our targeted nutrition pathway specifically, please use the link below.
Referral inclusion criteria
Please review the following before making a referal.
- Confirmed cancer diagnosis
- 18 years old and above
- Able to access the programme independently or with support from family or carer
- Has provided informed consent to be referred to the programme
Please see our ” Who’s It’s For ” page for more details about the programme: www.pennybrohn.org.uk/prehab/whos-it-for/