Referrrals for Common Ground and Community Champions
Thank you for your interest in the services of Re:dish. Referral forms can be submitted by an individual on their own behalf or by someone else on their behalf and with their consent.
You have two options to complete the form:
- If you are an organisation, who is completing the form on behalf of another person. Please print and enter your details using this Referral Form and send the completed scanned entry, by email, to Gemma.
- If you are an individual completing this form for yourself, or another. Please enter your details below.
If you need assistance to complete the form please email Gemma or call on 07498 996 634.
Providing you are happy to do so, can you also complete the Client Equal Opportunities Monitoring form.
Confidentiality: the information on this form will be treated as Confidential and will only be used by Re:dish to enable to provide support. We will only give information to other people, if you give us permission to do so.
Access needs: please inform us of any access requirements that you may have, eg information in large print. We will try our utmost to accommodate your needs.
Acknowledgement of receipt: we aim to acknowledge receipt of your Referral Form within 5 working days. If you have not received this within 5 working days please contact by telephone on 07498 996 634. or email Gemma.