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Insight Eating Insight Health
  • Home
  • Meet the team
  • Who we help
  • Services
    • Service Information
    • Services for HCPs
  • Contact
  • Blog
This field is for validation purposes and should be left unchanged.

Welcome back – Self-Referral Form

Have you seen someone at insight before and are interested in accessing our services?
Please fill out the form below and we will get in touch as soon as possible.

Concerned about your data? Please see our Privacy Policy
Have you been seen by IEIH before

If you have not been seen by insight before please complete our New Referrals Form.

Contact Details

(e.g. parent, partner, carer, clinician)
Your Name(Required)
The person completing this form

Important From this point on, all questions should be answered about the person this form is about, not you. Please provide their details, information, and experiences.

Name(Required)
Are you over 18?

Insight has age restrictions depending on the services that you need. We see ages 8+ for ARFID and 15+ for other eating disorders.

Address

Many thanks for contacting IEIH. A consultant will be in touch via text to discuss your enquiry. Please provide your preferred telephone number below.

Email(Required)

Insight Eating Insight Health Services (IEIH)

Would you prefer to continue with the same therapist, or would you like to see someone different?
Please note that either option is absolutely fine—we aim to ensure the best fit for you.
How will you fund any sessions with IEIH?
If applying for funding, if you are not successful, are you willing to self-fund?
Consent(Required)
Data will not be shared with advertising agencies or third parties. Data may only be shared with healthcare professionals (HCPs) with your express permission and solely for the purpose of providing treatment services. You can request access, correction, or deletion of your data at any time by contacting us and requesting removal.

Please see Privacy Policy

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