Application Form

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How to join a group / make a referral

We operate an open application system. This means that you can self-refer or refer a friend, relative, or patient/client – no matter who you are.

We ask you to complete the form and send it to us by:

Email:, or

Post to: Aphasia Re-Connect

17 Elm Road,


Kent BR3 4JB

For help or more information: Contact Us