Primary Care Gambling Service Registration Form

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Please complete this form to register for the Primary Care Gambling Service. All personal information provided will be handled and stored in full accordance with GDPR requirements. If you have any problems with this form please contact us, or call 0300 0300 111 during office hours.

Out of office hours, you can also contact the National Gambling Helpline, to arrange a referral – call Freephone 0808 80 20 133 or web chat via the website (available 24 hours a day).

If you would prefer to have this form emailed or posted to you please contact us or call 0300 0300 111 during office hours