Accommodation referral
Accommodation referral
Please complete the form fully and accurately, as missing information may delay our response and could affect service access.
You can access our referral form using the button below.
When completing this referral:
The more information you provide will help us to better understand the persons specific needs and circumstances. Once this form is complete a DASH risk assessment form MUST be completed to progress this referral further forward.
Missed information can delay the decision making and even result in the refuge place being offered to someone else.
If you have any questions regarding the eligibility criteria, or how to make a referral, please contact 07845 443 840
Eligibility criteria for refuge service:
Any person aged 18 or over with or without children fleeing domestic abuse. We will consider all referrals from:
- People with mental health needs
- People misusing substances or substances dependency.
- People evicted from a refuge before
- People with alcohol dependency support needs
- Ex – offenders
All decisions are made on an individual basis and will depend on the level of support need and space available.