Refer Yourself to LGBTQ+ Support Services | MESMAC

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Refer Yourself to LGBTQ+ Support Services

Refer yourself to MESMAC's LGBTQ+ support services using our online form. Tell us about you and our team will be in touch.

Use this form to refer yourself to Bradford Yorkshire MESMAC LGBTQ+ support services. We aim to contact you within 24 hours after receiving your referral. Please note that we don’t usually work weekends.

What kind of support are you looking for? 

Please be aware that we only cover Bradford Metropolitan District postcode areas.

How would you describe your sexual orientation?  
How do you describe your gender? 
Is this the same as the sex you were assigned at birth?
Are you able to communicate easily in English?  
Do you have a disability?  

We will contact you for more information and if we need to make any adjustments

Please be aware that we only cover Bradford Metropolitan District postcode areas.

Do you have any mental health or neurodivergent conditions (anxiety, dyslexia, autism etc.) ? 
Do you have any mobility issues?  
Do you have a carer (someone who helps care for you)?  
I have read and understood the Yorkshire MESMAC privacy statement and agree to the use of my data in line with this policy  

Find link to privacy policy at the bottom of the page

Thank you for taking the time to fill this out, our service is confidential and all the information given here will be destroyed after we have made you a confidential service user number. 

Yorkshire MESMAC Privacy Policy

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Read our privacy statement