This referral has NOT been sent yet. You will be redirected to the listing's external referral form. Please complete the referral form there to submit the referral confirm Details Adult Weight Management Service - Wandsworth & Richmond by Richmond and Wandsworth Adult Weight Management (Enable) Who is this referral for? I am signing up myself I am referring someone else Service access criteria Tick to confirm you have checked the service access criteria "To access the programme participants must be: Over 18 Adults with a BMI between 30 and 40 Black, Asian and minority ethnic (BAME) adults should have a BMI between 27.5 and 40 Exclusion criteria: Pregnant Adults with complex obesity and/or comorbidities - with a BMI 40 kg/m2 or more Pre-diabetic (42-47 mmol/mol) " Your Details Email Email is invalid We already have an account with this email. Please log in. Password Reset my password Log in First name Last name Your relationship to the person Organisation name Who are you referring? First name Last name Known as Date of birth Email Don't know / client doesn't have an email address Phone Address Line 1 Address Line 2 Town/City Postcode GP surgery NHS number Ethnicity SelectEnglish, Welsh, Scottish, Northern Irish or British Irish Gypsy or Irish Traveller Any other White backgroundWhite and Black Caribbean White and Black African White and Asian Any other Mixed or Multiple ethnic backgroundIndian Pakistani Bangladeshi Chinese Any other Asian backgroundAfrican Caribbean Any other Black, African or Caribbean backgroundArab Any other ethnic groupPrefer not to say Gender SelectFemale Male Transgender female Transgender male Non-binary Intersex Not specified Not known Other Additional referral details Do not enter protected health information (PHI) or any other personal data in these fields. What are the reasons for this referral? Sedentary lifestyle High body weight Finances Caring responsibilities Loneliness/isolation Employment Food Poverty Covid/Long Covid Mental health Substance misuse Transport Legal advice Managing a long-term health condition Day-to-day helping hand Victim of abuse Housing problem Bereavement Hypertension (controlled) Type 2 diabetes Hyperlipidemia Other: This field is required. Should the service provider be aware of any additional needs? Blind/partially blind Memory problem Hearing loss Housebound Does not speak English Poor mobility Learning and communication needs Physical disability Frail Other: This field is required. Please share some brief details regarding this referral Borough Wandsworth Richmond This field is required. Please select the programme/s that you can attend SelectBattersea January 2026 Waiting List Tooting January 2026 Waiting List Putney January 2026 Waiting List Roehampton January 2026 Waiting List Whitton October 2025 Waiting List Barnes October 2025 Waiting List Twickenham October 2025 Waiting List Kew October 2025 Waiting List Hampton Hill October 2025 Waiting List Body Mass Index (BMI) - (if above 40kg/m2 please refer to Tier 3 Weight Management) Client's height measure (m) Client weight measure (kg) Is this referral from an NHS health check? Yes No This field is required. Referrer's relationship to the client i.e. Doctor or Social Prescriber Primary Care Network West Twickenham PCN - Richmond Teddington PCN - Richmond Sheen & Barnes PCN - Richmond Richmond PCN - Richmond Hampton PCN - Richmond East Twickenham PCN - Richmond PRIME PCN - Wandsworth West Wandsworth PCN - Wandsworth Balham, Tooting & Furzedown PCN - Wandsworth Grafton PCN - Wandsworth Wandle PCN - Wandsworth Brocklebank PCN - Wandsworth Nightingale PCN - Wandsworth Battersea PCN - Wandsworth Wandsworth PCN - Wandsworth This field is required. GP Practice The Mayfield Surgery Tudor Lodge Health Centre Chartfield Surgery The Heathbridge Practice The Danebury Avenue Surgery The Alton Practice The Roehampton Lane Surgery Putneymead Group Medical Practice Balham Health Centre Tooting Bec Surgery The Practice Furzedown Streatham Park Surgery Trinity Medical Centre Open Door Surgery The Greyswood Practice Tooting South Medical Centre Bedford Hill Family Practice Grafton Medical Partners Triangle Surgery Elborough Street Surgery Earlsfield Surgery Southfields Group Practice Wandsworth Medical Centre The Haider Practice St Pauls Cottage Brocklebank Group Practice Nightingale Practice Thurleigh Road Practice Balham Park Surgery Battersea Rise Group Practice Queenstown Road Surgery Battersea Fields Practice Lavender Hill Group Practice Bridge Lane Group Practice Clapham Junction Medical Practice Bolingbroke Medical Centre The Begg Practice The Junction Medical Practice Falcon Road Medical Practice Chatfield Health Care York Medical Practice Cross Deep Surgery Woodlawn Medical Centre Crane Park Medical Centre Park Road Surgery Broad Lane Surgery Hampton Medical Centre Parkshot Medical Practice Seymour House & Lock Road Surgery Kew Medical Practice Vineyard Surgery Paradise Road Surgery Richmond Medical Group Sheen Lane (Johnson) Glebe Road Surgery Essex House Surgery Hampton Hill Medical Centre Thameside Medical Practice Hampton Wick Surgery The Green & Fir Road Surgeries Twickenham Park Surgery Richmond Lock Surgery Acorn Practice Jubilee Surgery Staines Road Medical Centre Other: This field is required. Does the client have a learning disability? If yes, please note this below What is your current smoking status? Never smoked Former smoker Current smoker – occasional Current smoker – daily Currently trying to quit smoking This field is required. Is the client currently on weight loss medication? Yes No This field is required. If yes, how is this medication being accessed? NHS Privately The client is not taking weight loss medication This field is required. Confirmation and consent Tick to confirm you have gained consent to share this information with the service provider, your organisation and Joy Tick to confirm the service provider can directly contact the client Would you like to create an account? Make referrals faster next time you use Joy. Registered users can message service providers, submit reviews and track the progress of their referrals online. Password Weak password! Use at least 8 characters Use upper and lowercase characters (a-z) Use 1 or more numbers (0-9) Confirm password Please enter the same value again. required Submit Email: Password: Email
