Teletherapy form

NHS teletherapy or telehealth  application form.

Use this form to express an interest in using the adult therapy 'telehealth' service, run by Airedale NHS Foundation Trust. 

Teletherapy is only available if there is no NHS service where you live, so please contact your local service first. For details on how to do that, see our Finding a NHS therapist page.

If you have done that and been told that there isn't a service, you can then apply for teletherapy by completing the form below. We will forward your form on to Airedale NHS.

Please note this service is only available for people living in the UK. If you live outside of the UK, try contacting the International Stuttering Association to see what help is available where you live.

Teletherapy application form