Make a Referral

We accept referrals from homeless organisations or government agencies only.

If you are currently homeless and not in contact with any other organisation and you are looking to gain support to help move forward we can sign post you to someone who can help with your direct needs. Please use our contact form found here.

Organisations and Goverment agencies can make a referral via the following online form - please ensure you have all the clients relevant information before submitting this form - if the form is incomplete we may not be able to process the referral.

We are able to offer support to a number of clients with a broad range of support needs including:

  • Ex Offenders
  • Abuse sufferers
  • Recovering Addicts
  • Mentally ill
  • Learning Difficulties

If we provisionally accept the application, your client will be invited to an assessment meeting at our office, where they will be asked to produce:

  • Photo ID (passport, driving licence, citizenship card);
  • written confirmation that they are in receipt of Universal Credit and entitled to housing benefit;
  • current bank account details;
  • evidence of leave to remain in UK (if applicable).
NOTE - We ask you to pay particular attention to the section covering your client’s support needs and to be aware that you/they may be required to supply documentary evidence (e.g. medical conditions/diagnoses, criminal convictions, victim support/DV etc.,) for our records. If necessary, you will need to obtain the person’s written consent to share such data with us under the DPA/GDPR protocols. Wherever practicable, we will expect to see the applicant’s own description of the support they seek and an indication of their willingness to engage in the project. The information provided will form the basis of a bespoke support plan. Once we accept the application, you (the referrer) will be required to submit a copy of the completed referral form to our local authority for authentication

We will hand our terms and agreement policies at the face to face meeting which will need to be signed and agreed to by the client.

We aim to keep everyone updated and informed with reguards to every stage of the referral.

We will email updates to you and the client at each stage of the process, and also update you on the clients progress with us periodically after they have been accepted for our support.

Please complete this form in full - incomplete forms may not be processed

Please read What we do - and Who for - to see if our supported housing options will work for your client.

Referral Agency Details


Clients Information


Risk Assessment

Please help us understand the clients needs by selecting which risk factors apply. Please think broadly about each statement.
Select all statements that apply - Leave blank if no risks and please add in any specific information to best help us understand the clients support needs.

Lone Working

Emergency Responce

Support Needs Assessment

We aim to offer as much support as possible, please use the next section of this form to help us assess the support needs of the client. Please provide as much information as possible. If a section does not apply please leave blank.

Help with finding and maintaining a home, help with living with others and working on to independant living
I need support with housing related issues
Please give more information

Help with benefits, managing money, paying bills and debt issues
I need support with finances
Please give additional information

Physical health and wellbeing
Help with diet, exercise, self harm and medical appointments etc
I need support with my physical health and wellbeing
Additional Information

Mental Health and Wellbeing
Help with managing free time, social situations, depression, anxiety, or other mental health issues.
I need support with my mental health and wellbeing
Additional Information

Substance missue
Help with managing addiction
I need support with my substance missue
Additional Information

Offending behaviour
I need help with offending behaviour, violence, aggression, stealing or other offences
I need support offending behaviour
Additional Information

Domestic Abuse
Please let us know of any current support you recieve along with any support needs you have
I need support with Domestic Abuse issues
Additional Information

Legal Support
Areas not covered previously under offencive behaviour, such as divorce, child visitation, asylum etc
I need support with legal help and advice
Additional Information

Disability Needs
Help us understand any additional disability needs you have to help us better support you, include any physical disabilities and learning disability
I need support with disability factors
Additional Information


Confidentiality and Consent

I give my consent for the information that I have given to be shared internally and between Elevating Lives and relevant agencies in order to access accommodation and services in relation to my identified needs. *

It has been explained to me that this information will be held on a database, will remain confidential and will not be shared with any other agency without first seeking my permission *

I understand the only exception to this will be where Elevating Lives has serious concerns about the personal safety of myself or others. Example of there concerns include if I am contemplating suicide or self harm, if there is a genuine threat of violence against others, or where staff are summoned by a court order to give evidence. *

Thank you for completing this form

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