LDAR Project Complementary Therapy Service Healthy Valleys, 31 Stuart Terrace, Rigside Lanark ML11 9NN Telephone 01555 880 666 Contact details: Carol Hamilton Mob. No 07702336327 Email: carol.hamilton2@nhs.net As part of the Lanarkshire Domestic Abuse Response project (LDAR) Healthy Valleys provide free complementary therapy sessions to women who are experiencing (or have in the past experienced) domestic abuse which has impacted on their health. The LDAR project aims to improve access to specialist practical & emotional support enabling more women to become survivors of domestic abuse and to move forward in their lives. The complementary therapies are on offer to women who live in the Lanarkshire area where the referral agency feels bodywork therapies would help the client in her recovery process and where one or more of the following symptoms have been experienced for longer than a month: Sleep problems Physical health problems Anxiety / panic Low self esteem Emotional numbness Difficulty with talk therapy Difficulty with touch. Benefits of bodywork therapies can include: Improved sleeping Reduced physical tension Reduced anxiety / depression Improvements in physical symptoms (i.e. digestive health, headaches etc.) Increase in confidence & overall wellbeing Clients referred will have a consultation with the therapist on the first meeting and will discuss an appropriate course of therapy to suit the individual’s needs. Treatments available are Aromatherapy & Aromatherapy Massage Indian Head Massage Pregnancy Massage Shiatsu If you feel your client meets the criteria and would benefit from this service please complete the request for assistance form below and return it to carol.hamilton2@nhs.net or if you have any questions please do not hesitate to contact Carol on 01555 880 666. Healthy Valleys is a Company Limited by Guarantee No: 246145 and is a recognised Scottish Charity No: SC034253 LDAR Project Complementary Therapy Service Request for Assistance Please ensure all sections are completed in full TO BE COMPLETED BY THE REFERRAL AGENCY (please ensure you have read criteria above) In my opinion Click here to enter text. is a suitable candidate for the LDAR project and I would like to refer them to the complementary therapy service. Name of Referral Agency Click here to enter text. Address of Referral Agency _Click here to enter text._____________________________________________ Signature of Person Referring Click here to enter text. Date Click here to enter text. Contact Telephone Number of Referral Agency Click here to enter text. REASON FOR REFERAL – Please tick appropriate boxes (to qualify client must have experienced domestic abuse and at least one other box must be ticked) Client experiencing domestic abuse: Currently ☐ In past ☐ ☐ Physical Health problems ☐ Low self esteem Emotional Numbness ☐ Difficulty with talk therapy ☐ Difficulty with touch ☐ Sleep Problems Anxiety / Panic Comments: ☐ Depression ☐ ☐ Click here to enter text. CLIENT DETAILS Name Click here to enter text. Address Click here to enter text. Postcode Click here to enter text. Safe contact details (i.e. phone no, email or address) Date of birth Click here to enter text. Space for any other relevant information Safe to contact? Click here to enter a date. Preferred location to attend Able / willing to travel within Lanarkshire? By Letter ☐ By Phone ☐ By Email ☐ Click here to enter text. Yes ☐ No ☐ Click here to enter text. Data Protection Act 1998 Information will be kept for no longer than necessary and stored in the most appropriate way. We may also pass on your details to other organisations associated with the project.