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Referring to BPAS

Call 03457 30 40 30 to refer to BPAS for treatment.

  • You or your patient can make the telephone call to book.
  • GPs or other healthcare professionals may call our Referral Support Hotline on 0333 234 2435 if you want to refer a patient with complex medical needs, if your patient is vulnerable, or you have other concerns.
  • Calls are charged at a local rate.
  • Phone lines are open Monday to Friday: 7am - 6pm Saturday: 8am - 4pm Sunday: 9.30am - 2.30pm
  • Appointments are available from approximately 55 clinics located across England, Wales and Scotland

Referral forms are available below

Referral Form

Download

Termination of pregnancy (TOP) 

PDF and Word (protected), allows completion of form fields only.

Word (unprotected) to load to your information systems.

PDF Termination of Pregnancy Referral Form

Word (protected) Termination of Pregnancy Referral Form

Word (unprotected) Termination of Pregnancy Referral Form

Termination of pregnancy for fetal anomaly

There is an alternative patient pathway for TOPFA referrals from NHS Units. Please print the PDF, complete and fax or email it to the treatment unit or contact centre.

Fetal Anomaly Referral Form (PDF)

Prison healthcare providers 

Refer clients in custody by completing the referral form and emailing it to custodial.referrals@bpas.org.

For more information about how we treat women who are serving a custodial sentence click here

Prison Custody Termination of Pregnancy Referral Form (PDF)

Vasectomy referral forms

PDF and Word (protected), allows completion of form fields only.

Word (unprotected) to load to your information systems.

PDF Vasectomy Referral Form

Word (protected) Vasectomy Referral Form

Word (unprotected) Vasectomy Referral Form

HSA1 Form

HSA1 Form (PDF)

HSA1 Form (Word)

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