Independent Mental Capacity Advocacy (IMCA) Referral Form

Independent Mental Capacity Advocacy (IMCA) Referral Form

Part 1: Independent Mental Capacity Advocacy (IMCA) Referral


YesNo

YesNo

3. Decision Maker (if the referrer is the decision maker please select the box below)

Yes

YesNoNot yetPerson lacks understanding or awareness

Part 2: Referral Information

YesNo

YesNo

Non-binary refers to individuals who don’t see themselves as either male or female. Individuals identifying as non-binary may ask you to use gender neutral pronouns such as they/their rather than he/she. Please do not ask non-binary individuals the sex or gender assigned to them at birth as this is irrelevant.

Trans male/female refers to individuals who are transitioning to the gender they identify with.

Pansexual refers to individuals who are romantically, emotionally, sexually attracted to people regardless of their sex and gender identity.

I’m not sure if advocacy is what I need