Expressions of Interest Form



If you say yes to SMS, we can send you text messages about Connect to Work.




  • If a GP, nurse, or someone at your doctor's surgery told you, choose Primary Care.
  • If someone from a community service helped you (like a pain clinic, physio, mental health support, or social prescribing), choose Community Care.
  • If it was someone else, please tell us who.

NB: Always seek to complete NI Number, if not available today politely request client to bring it to the next appointment

If you are employed, it means you have a job and someone pays you to do it.
You might:
  • Work full-time or part-time.
  • Get paid weekly or monthly.
  • Work in a shop, office, school, hospital, or somewhere else.
  • Have a boss or manager who tells you what to do.
Being self-employed means you work for yourself. You run your own business and are in charge of whether it does well or not.
You might:
  • Have your own trade or job (like a builder, hairdresser or artist).
  • Pay your own tax and National Insurance.
  • Not get paid through a company's payroll (PAYE).
  • Not have the same rights as someone who is employed by a company.
If you're not sure, you can learn more at: www.gov.uk/employment-status/employee

You are disabled if you have a physical or mental difficulty that makes it harder to do everyday things.
You might also be disabled if things around you make life harder - like buildings without ramps, buses you can't use, or people thinking you can't do something just because of your condition.
A long-term health condition is something that affects your body or mind for a long time - usually 12 months or more.

NB: Is this participant suitable for an SMI referral?




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