Use this form for referrals into the Wellness Works programme.

Please use this form to refer yourself or someone else to the Wellness Works programme. We support people with health-related barriers to work through our Keyworker Programme and by connecting residents to their local Health Hub for community-based activities and support.

If you are making this referral on behalf of someone else please ensure you have obtained their consent first. Please give us your details as well as theirs, when asked.

This activity is managed by TSL Kirklees and is part of Healthy Working Life, a joint programme of the West Yorkshire Combined Authority and NHS West Yorkshire Integrated Care Board.

Wellness Works Referral Update

Referrals to the Wellness Works programme are now closed as the programme is coming to an end.

We understand that many people may still be looking for support with their wellbeing, mental health, or employment. If you need support, the following services may be able to help:


I am making a referral for...

Referrer Information

Do you have consent from the individual to share their information with us?

We are unable to accept referrals without consent from the individual

About You

Please complete the form below. If you don't have your NHS Number and National Insurance Number you can still submit the referral but we do need this information so please have both ready when we contact you about your referral.

In order to process your referral, we need to be able to contact you. If you provide an email address, we will contact you by email. If you provide a mobile number, we will call you or text you. The contact will be made from your nearest Wellness Works Delivery Partner. You can change these contact preferences at any time - but we must have at least one means of contacting you.

About the Individual being Referred

Please complete the form below. If you don't have the NHS Number or National Insurance Number you can still submit the referral but we do need this information and will gather it from the individual when we contact them.

In order to process this referral, we need to be able to contact the individual. If you provide an email address, we will contact them by email. If you provide a mobile number, we will call them or text them. Contact will be made from the individual's closest Wellness Works Delivery Partner. The individual can change these contact preferences at any time - but we must have at least one means of contacting them. By submitting this referral you confirm you have obtained consent for us to contact the individual as you have indicated above.
e.g. safeguarding concerns

Reason for Referral

What level of support is required?
e.g. wheelchair user, non-English speaker etc

By submitting this form you confirm that you have read, understood and accept the Wellness Works Privacy Policy which outlines how we will gather, store and share your data.