External Therapy Referral Form Logo
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  • Welcome to HSTAR Scotland SCIO External-Referral Form

    Our purpose is to support women in rebuilding their lives after experiencing trauma and abuse. HSTAR offers trauma-sensitive, person-centred support to women affected by past trauma, abuse, and mental health challenges. All information provided in this form will be kept confidential and will not be shared outside the charity without your explicit written consent. However, in rare cases where there is a credible risk of harm, we reserve the right to breach confidentiality.
  • Eligibility

    We aim to provide free services to all eligible women in the Forth Valley. However, please be aware that fully funded services may not always be available due to changing funding situations and current projects. If there is no secured funding for the area in which the person you are referring resides, we will offer them the choice of either beginning partially funded sessions or placement on a waiting list. If the person you are referring resides outside the Forth Valley area, we can only offer counselling services on a partially funded basis.
  • 1.

    We can accept referrals for women who are over 16 years old, reside in Scotland, and are in a safe personal space/environment. After receiving the referral, we will conduct an intake assessment telephone call with the referred individual within a maximum of 4 weeks. If eligible for our services, the average timeline to be matched with one of our therapists and begin trauma recovery therapy is approximately 6 weeks, depending on the individual’s needs and availability
  • 2.

    The referred client may be matched with therapists in training who are completing their placement with HSTAR Scotland. All student therapists are thoroughly screened, insured, registered members of COSCA/BACP, and receive full clinical supervision.
  • 3.

    HSTAR Scotland operates a minimum 24-hour cancellation policy. If the client cancels a session with less than 24 hours’ notice or does not attend an appointment, HSTAR Scotland will issue a late cancellation fee of £40, which must be paid before the next session can be booked. HSTAR Scotland provides short-term support (up to 18 therapy sessions; other services may vary). In line with our support model, only two cancellations are permitted within the allocated service block. As a small charity, this cancellation policy is essential to ensure timely communication, enabling us to effectively manage our limited resources and continue offering vital services to those in need. We appreciate your understanding and cooperation.
  • 4.

    For therapy and mental health and wellbeing sessions the client will be required weekly attendance; we do not offer flexible or biweekly scheduling options.
  • 5.

    Based on our terms and conditions and current funding availability, the client may be required to pay a refundable deposit of £40. This deposit will be returned to the nominated bank account within 14 working days following the client’s final session with our services. Please note, the refundable deposit scheme does not apply to partially funded therapy.
  • 6.

    We will offer the client a therapy modality based on their individual healing needs and matched with the availability of a suitable therapist.
  • 7.

    While we evaluate each case individually, it may be determined that HSTAR Scotland is not the most suitable option for your client presently. To prevent extended waiting periods and disappointment, kindly consider the following guidelines when referring a client: We may decline or postpone a referral if a woman: - Currently has a complex mental health diagnosis, severe substance abuse issue, or severe eating disorder. - Is not in a safe environment and exhibits risks of self-harm or suicidal tendencies. If you indicate that the client has obsessive thoughts or poses a risk of self-harm or suicide, it is mandatory to provide additional information to the charity detailing the level of risk and how it should be assessed. - Is already undergoing therapy elsewhere. - Is in the midst of an active mental health or neurodiversity diagnostic process. - Seeks counselling to support a legal case or is court-ordered for therapy. - Resides with or is in a relationship with the perpetrator of abuse. - Uses your organisation's email address as this violates our privacy and confidentiality policies regarding external email communications with individuals.
  • Personal Information of the Referred Individual

    Please tell us about the person you are referring to us.
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  • Emergency contact

    Please ask the referred individual to provide us with an emergency contact.
  • Which GP practice are they registered with? 

  • Reason for referring to HSTAR Scotland

    Please select the options below that match their situation.
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  • Referrer Information

    Please provide details about yourself.
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  • Confidentiality and Privacy

    Respecting your confidentiality and privacy is fundamental to our practice. Your form will be stored securely and governed in line with our GDPR. We will not share your information with anyone outside our practice, unless we believe you are at imminent risk of harm (or a child or vulnerable adult is at a serious risk). In this instance we are legally bound to share basic information in order to keep you (or a vulnerable other) safe. *
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