Our Turn to Us project works with parents to help them make their voice heard. We can help with either Peer Advocacy or Self-Advocacy.

If you would like to make a referral to us for support, please fill in the form below. If you are having trouble with the form, please email us at [email protected] and we will look at how we can help you refer in another way.

Download our Word Referral Form

If you are unable to complete the online referral form on this page, we have a Word version of the form. To use it, please fill it in, save it and send it by email to [email protected]. Download a copy by clicking on the button below.

Make a Referral

    This referral form is for our Turn to Us project. You can complete this form on your own behalf (self-referral) or on behalf of someone else. Parts 1 and 2 must be completed as a minimum. Then, depending on the advocacy required, please complete other relevant parts. Incomplete forms may result in delays in allocating an advocate.

    Data entered on this page will be stored by The Advonet Group on our secure database. Do you consent to this?

    Part 1: Type of Advocacy Required

    Advocacy required:

    How did you hear about this service?

    Date of referral:

    Part 2: Referral Information

    1. Relevant Person’s Details: (this is the person who needs advocacy)

    Name:

    Home (usual) Address:

    Current Address or Location:

    Preferred contact method:

    Email address:

    Contact number:

    Can we leave a message?

    Date of birth:

    Gender:

    Is your gender the one you were assigned with at birth?

    Ethnicity:

    Religion:

    Sexuality:

    Consent to make a referral for advocacy:

    Name of person giving consent:

    2. Reason for advocacy referral? (Please include a summary of the advocacy issue/decision being made, upcoming meeting dates, deadlines, priority areas etc)

    Reason for referral:

    3. Referrer Details:

    Referrer Name:

    Job Title:

    Employer:

    Secure email:

    Tel. No.:

    Place of work (including address)

    4. Friends and/or family: (Is there an appropriate person to support the person’s involvement?)

    Is there anyone (e.g. friend/relative) who you are consulting with?

    What is their relationship to the person requiring advocacy?

    What are their contact details?

    Are there any current Risk Issues we need to be aware of?

    Type any risk issues in this box:

    5. Other relevant information about the person requiring advocacy.

    Any support needs?

    Other support needs?

    Is the person a carer?

    How does the person communicate?

    What is the person’s first language?

    Other relevant information?

    Glossary of Terms

    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.