Southern Brooks Community Partnerships

Wellbeing Coach - Self Referral

You can use this form to refer yourself to a Wellbeing Coach at Southern Brooks. (If you are a professional and would like to make a referral for your client instead, please use this form.)

This service is about helping people to make small changes to improve their wellbeing. We can do this by offering a 30-minute phone call with one of our Wellbeing Coaches, who will make a wellbeing plan with you about small steps you can take and give you information about other services in your area that might be helpful. You will also receive a few check-in phone calls after this session, to help motivate you with your wellbeing plan.

Having a feeling of wellbeing means:

  • to have good mental health
  • being satisfied with your life
  • feeling that you have meaning or purpose
  • being able to manage stress well

If you would like to find out more about our service, you can see our Frequently Asked Questions here

Eligibility criteria:

  • Over 18
  • Would like to make a Wellbeing Plan, and feel ready to make small changes to your lifestyle in order to improve your wellbeing
  • Either:
    • a resident of South Gloucestershire
    • registered at a South Gloucestershire GP surgery
    • a Bristol carer for someone living in South Gloucestershire

If you have any questions about the service, or need to refer yourself in another way, please email wellbeing@southernbrooks.org.uk or call (01454) 868583.


Referral Form

Wellbeing Coach Self Referral

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Equalities Questions

How do you describe your gender? *
Do you consider yourself to be transgender or as having a transgender history?
What is your sexual orientation?
Do you have a religion?
What is your ethnicity?
Do you see yourself as disabled?
Are you a carer?
What is your employment status?