Caniad Referral

You can refer yourself to Caniad by free phone 0800 085 3382 or by email to or by contacting a member of staff from our contact page.

Alternatively, if you are a professional wishing to refer someone please find our referral form below.

Please choose the options that apply to the person being referred.
Please let us know of any personal, medial or other conditions that we may need to be aware of before contacting you.
Name of the person filling out this form